Improving the follow-up of children and adults with prematurity-associated lung disease

INTRODUCTION: With the advances in neonatal care over the last three decades leading to improved survival from preterm birth, it is becoming increasingly evident that preterm-born individuals experience respiratory morbidity and reduced lung function through the life course, now termed prematurity-associated lung disease (PLD), with increasing concern regarding the onset of chronic obstructive pulmonary disease in early adult life. AREAS COVERED: In this article, we will cover the current evidence for screening, monitoring and management of PLD. We shall discuss monitoring strategies utilizing lung function testing, lung imaging, and oximetry, amongst others. Although current data regarding optimal management and treatment are limited, we shall discuss pharmacological and non-pharmacological methods currently for PLD. EXPERT OPINION: It is now clear that long-term respiratory follow-up for high-risk preterm-born individuals is imperative to identify PLD early, monitor its progress and optimize respiratory outcomes. There must be increased recognition from pediatric and adult physicians of the impact of prematurity and low birth weight on respiratory health in later life, with services developed to transition individuals with PLD from pediatric to adult care. Future research should aim to improve understanding of PLD phenotypes and phenotype-targeted interventions to optimize respiratory health in PLD across the life course.