Prematurity-associated lung disease: is it asthma?

Survivors of very preterm birth (<32 weeks gestation) experience lung health deficits that may be progressive over time [1]. Respiratory symptoms are frequently diagnosed as asthma in this population with studies reporting that children born preterm (<37 weeks gestation) are up to 5 times more at risk of developing wheezing disorders than their term-born counterparts [2], and that up to 50% of children born very preterm are diagnosed with asthma by mid-childhood [3]. Contrary to the childhood asthma paradigm, this patient population is typically non-atopic [4] with low fractional exhaled nitric oxide (FeNO) [5]. Furthermore, studies of inhaled corticosteroids (ICS), which are commonly used to treat asthma, report only modest improvements in lung function for those born very preterm [6]. Indeed, some have argued that the term "asthma" should be avoided when describing prematurity-associated lung disease, especially since the underpinning mechanisms remain unclear [7]. It is highly important to distinguish between asthma and prematurity associated lung disease in this population, to guide appropriate treatment and follow-up for these individuals. Footnotes This manuscript has recently been accepted for publication in the ERJ Open Research . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article. Conflict of interest: None of the authors have a conflict of interest to disclose.