Abstract Rationale Children with Bronchopulmonary Dysplasia (BPD) experience increased respiratory morbidity, impaired exercise capacity and reduced lung function. However, there are currently no well-established qualitative assessments of respiratory morbidity in survivors of premature birth. The Saint George Respiratory Questionnaire (SGRQ) has consistently demonstrated the ability to distinguish severity and clinically relevant symptoms in adult obstructive lung disease but has not been used widely in pediatrics. Methods We applied a modified SGRQ to a population-based prospective observational cohort study of children born preterm under 33 weeks gestational age with and without BPD compared with controls matched for age, sex, and social deprivation index. SGRQ and spirometry were completed at six years of age. BPD was classified using Jensen criteria. Z-scores were used for spirometric parameters according to the Global Lung Function Initiative equations. Descriptive statistics are presented as median and interquartile ranges (IQR), group comparisons were performed using Kruskal-Wallis test, followed by post-hoc analysis with Dwass-Steel-Crichtlow-Fligner. Correlations were assessed using Spearman’s rank coefficient. Results 141 patients were included; 23.4% grade 1 BPD, 13.5% grade 2 BPD, 5.7% grade 3 BPD, 38.2% premature children without BPD (PT) and 19.1% term controls. Median total SGRQ for all preterm children had a clinically significant increase (5.212.8 v 1.81.5, p 0.001); similar increases were seen for symptoms subscore (19.627.3 vs 10.35.3, p 0.001), activity subscore (015.4 vs. 00, p = 0.003) and impact subscore (010.6 vs. 0(0) (p = 0.002). There was increasing total and subdomain score with increasing BPD severity (Ptrend0.05). For those born preterm, FVC correlated with symptoms score (ρ=-0.65, p = 0.04) and impact score (ρ=-0.71, p = 0.02). FEV1 correlated with total score (ρ=-0.21, p = 0.04) and activity score (ρ=-0.24, p = 0.02) and FEF25-75 (ρ=-0.75, p = 0.02) correlated with activity score. Of the SGRQ’s 41 questions, 17 items differentiated the cohort into subgroups: presence of symptoms such as cough (p 0.001), wheezing (p = 0.02), respiratory exacerbations in the past year (p = 0.04), decreased exercise capacity such as inability to play sports (p 0.001) or walking uphill (p = 0.03) and parental perception of impact (p = 0.03). Conclusions The modified SGRQ captured clinically significant differences in respiratory symptom burden, activity limitations, and impact in children born preterm, with higher scores associated with increasing BPD severity. SGRQ scores were highly correlated with spirometry measures. These findings support the SGRQ’s potential utility in both clinical and research settings to monitor respiratory morbidity in this population. This abstract is funded by: Supported by the National Heart, Lung, and Blood Institute (R01 HL 1446689)
Elias et al. (Fri,) studied this question.