Respiratory outcome in three year old children with chronic lung disease

Survivors of the chronic lung disease (CLD) associated with prematurity have increased respiratory morbidity in childhood, but little is known about the outcome of CLD in the surfactant era. Our purpose was to evaluate the respiratory status in the first three years of life in children with history of prematurity with or without CLD. METHODS: A questionnaire was administered to the caregivers of a cohort of preterm and term infants (Clin Pediatr 34:290-9, 1995) which included three groups: High Risk (HR) with CLD (n=16); Low Risk (LR), no CLD (n=37); Term (T) (n=58) . RESULTS: Mean gestational ages were 28.8, 31.2 and 40 weeks for the HR, LR and T groups, respectively. The HR showed a higher frequency of sick visits/year (6 ± 8.0) as compared to the LR (3.7 ± 4.1) and T (2.2 ± 2.8) (mean ± SD, p<0.01). In year 1, the HR showed a higher mean number of hospitalizations (1.13) as compared to LR (0.65) and T (0.19)(p<0.01). The number of hospitalizations decreased in years 2 and 3 in all groups but remained higher in the HR group (p<0.006). The HR group had an increased incidence of asthma and respiratory infections compared to LR and T (p<0.01 for each year). Respiratory morbidity of LR group was more similar to the HR group in year 1, and to the T group in year 2-3. CONCLUSIONS: HR preterm infants with CLD have increased respiratory morbidity in the first 3 years of life compared to preterm infants without CLD and term infants, defined by outpatient sick visits, hospitalizations and episodes of asthma/respiratory infection. All groups improve with increasing age.