What question did this study set out to answer?

The research aims to identify early-life determinants of lung function in school-age children born preterm and analyze their long-term trajectories.

April 4, 2026

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School-age lung function after preterm birth: early-life determinants in a paediatric pulmonology cohort with comparison with NHANES

JKJelte KelchtermansChildren's Hospital of Philadelphia JRJessica L. RiceChildren's Hospital of Philadelphia BABrianna C. AoyamaJohns Hopkins University

Key Points

The research aims to identify early-life determinants of lung function in school-age children born preterm and analyze their long-term trajectories.
Examined predictors of FEV1 and FVC z-scores at ages 6-8 years using multivariable regression.
Evaluated spirometry patterns including pPRISm and POLD in a pediatric pulmonology cohort.
Applied longitudinal mixed-effects models to assess lung-function trajectories from ages 8 to 21 years.
Conducted parallel analyses using data from NHANES.
Lower weight-for-height at 4 years correlated non-linearly with school-age FEV1 and FVC.
Invasive ventilation during the first year led to significantly lower FEV1 and FVC.
pPRISm showed an inverse relationship with neighborhood income, while POLD was linked to invasive ventilation.
School-age pPRISm related to a progressive decline in FEV1, while POLD showed improvements in FVC.

Abstract

Introduction Lung-function outcomes among preterm-born children referred for pulmonology care are highly heterogeneous, and early determinants remain incompletely defined. We aimed to identify early-life factors associated with school-age lung function after preterm birth and to examine whether school-age spirometry patterns relate to subsequent lung-function trajectories. Methods Early-life analyses (n=511) examined predictors of forced expiratory volume in 1 s (FEV 1 ) and forced vital capacity (FVC) z-scores at ages 6–8 years using multivariable regression. Spirometry-based phenotypes included prematurity-associated preserved-ratio impaired spirometry (pPRISm), prematurity-associated obstructive lung disease (POLD) and prematurity-associated dysanapsis. Longitudinal mixed-effects models assessed lung-function trajectories from ages 8 to 21 years. Parallel analyses were conducted in the National Health and Nutrition Examination Survey (NHANES). Results Lower weight-for-height at 4 years was non-linearly associated with both FEV 1 and FVC at school age. Invasive ventilation in the first year of life was associated with lower FEV 1 (β −0.62, 95% CI −0.96 to −0.28) and FVC (β −0.54, 95% CI −0.92 to −0.18). In exploratory analyses, pPRISm was inversely associated with neighbourhood income (risk ratio (RR) 0.63 per SD increase, 95% CI 0.46 to 0.88), and POLD was associated with invasive ventilation (RR 8.07, 95% CI 3.33 to 19.5). Similar subtypes and associations were observed in NHANES. School-age pPRISm was associated with progressive FEV 1 z-score decline (age x pPRISm β −0.08 SD/year, 95% CI −0.15 to −0.02), while POLD was associated with improving FVC z-score (age x POLD β 0.13 SD/year, 95% CI 0.07 to 0.20). Discussion Early-childhood growth, neonatal respiratory exposures and school-age spirometry patterns help stratify long-term pulmonary risk among preterm-born children referred for pulmonary care.

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Cite This Study

Kelchtermans et al. (Thu,) studied this question.

synapsesocial.com/papers/69d0afb4659487ece0fa5c82 https://doi.org/https://doi.org/10.1136/thorax-2026-224740

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