Surprise Finding: Preemies Face COPD in Mid-20s

Babies born before full term face a host of medical complications. The earlier the birth, the more likely these complications will be severe and multiple. The baby’s lungs, not needed in the womb, are often affected by a preterm birth because they are some of the last organs to develop fully. Preemies almost always require a ventilator to help them breathe until their lungs become strong enough to breathe on their own.

Babies born earlier than 28 weeks of gestation are at particular risk of developing a respiratory condition called bronchopulmonary dysplasia (BPD) but preemies born after the 28th week are at risk for BPD, too. High levels of oxygen fed through the ventilator and ventilator pressure can create scarring of the lung tissue severe enough to cause BPD.

Adults born prematurely (ex-preterms) and diagnosed with BPD are at increased for developing chronic obstructive pulmonary disease (COPD), a disease usually associated with long-term cigarette smoking or exposure to industrial air pollutants. Most people are diagnosed with COPD when middle-aged or older. The disease is characterized by a difficulty to breathe, especially upon physical exertion.

Andrew Lovering, an associate professor of human physiology at the University of Oregon in Eugene, made a surprising finding in a study he recently conducted to compare the lung function of adults in their 20s who were born prematurely with that of adults of the same age born at full term. He studied three groups of young adults:

• 20 were born during or before the 32nd week of gestation and diagnosed with BPD
• 15 were born during or before week 32 but without a BPD diagnosis
• 20 control subjects were born full term with no medical complications

All study participants were subjected to the same series of physical activities designed to reach a 90% peak level of oxygen consumption. As expected, the ex-preterms reached peak lung capacity at lower rates of exertion than those born full term. The ex-preterms also experienced more leg discomfort than the control subjects born at full term.

The surprise finding of the study was that lung function in the preterm study subjects without BPD was about the same as that of the subjects who experienced BPD as preemies. The study suggests that anyone born before week 32 of gestation is at increased risk of developing COPD-like symptoms as a young adult.

At this time, details of childbirth are rarely considered when a patient presents with COPD-like symptoms, regardless of patient age. The study indicates even young adults born prematurely are at risk of reduced lung function similar to that of a much older person or a person who smokes tobacco products. A history of preterm delivery, with or without BPD, may indicate the need for COPD-specific medical interventions during young adulthood and in the absence of a smoking habit or exposure to risky air pollutants.


Sources:

1. "According to UO’s Andrew Lovering, preterm young adults may live with lungs of the elderly." Office of the Vice President for Research and Innovation. University of Oregon, 28 Apr. 2015. Web. 8 May 2015.
2. "What Is COPD?" NIH / National Heart, Lung, and Blood Institute. US Department of Health and Human Services, 15 Oct. 2014. Web. 8 May 2015.