477 - Long-term effect of early and late prematurity on cardiopulmonary exercise testing in childhood

Poster Number: 477
Publication Number: 477.433

Ori Hochwald, Rambam Medical Center, Haifa, Israel, Haifa, Hefa, Israel; Julie Haddad, Rambam Medical Center, Maalot Tarshoha, HaZafon, Israel; Liron Borenstein-Levin, Rambam Medical Center, Haifa, HaZafon, Israel; Amir M. Kugelman, Rambam Medical Center, Haifa, Haifa, Tel Aviv, Israel; Ronen Bar-Yoseph, Rambam Medical Center, Haifa, Hefa, Israel

Background: Early prematurity, with and without bronchopulmonary dysplasia (BPD), is associated with altered pulmonary function and exercise capacity. However, there is scarce data regarding short- and long-term effects on exercise capacity in the group of late preterms, born at 340 to 366 weeks' gestation (GA).

Objective: To evaluate the long-term effect of prematurity on exercise capacity in childhood.

Design/Methods: We studied children aged 7-10 years in four groups: early preterms born before 30 GA with (EP+) and without BPD (EP-), late preterms (LP) and control group of healthy children born >week 370 (TC). All participants completed a comprehensive functional evaluation using cardiopulmonary exercise test (CPET). The primary outcome was exercise capacity as measured by maximal oxygen uptake (peakVO2). Secondary outcomes included lung functions and other parameters from the CPET.

Results: Eighty-four children were recruited to our study (age 9.6±1.0 years, 48% girls), 15 former EP+, 23 EP-, 21 LP and 25 TC children. Lung function (forced expiratory volume in one second, FEV1) in the EP+ was significantly lower (75.6±14.9% pred, p < 0.05) compared to the other groups (EP- 87.8±12.5; LP 87.5±16.9; TC 91.0±11.7). Peak V̇O2, was within the normal range and comparable between all preterm groups but statistically lower than the term-born control group (EPM+ 97.3±25.5%;EP- 85.4±20.8%;LP 90.2±15.1%; TC 112.4±16.9%). Respiratory and cardiac limitations were similar between all four study groups.Conclusion(s): This study demonstrated lower exercise capacity in children aged 7-10 years with a history of prematurity compared to healthy term children, regardless of degree of prematurity and regardless of the diagnosis of BPD. Yet, the exercise test parameters, specifically peak V̇O2, were within the normal range and no significant physiological exercise limitations were found. Personalized follow up, focusing on respiratory and physical activity in all cases of prematurity should be encouraged. Further larger longitudinal studies are needed to better understand the specific characteristics of different preterm populations.