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Abstract
Our main objective was to study respiratory evolution and pulmonary and cardiac function in adolescents born preterm in the post-surfactant era. Observational cross-sectional study, comparing very preterm (< 32 weeks) and moderately-late preterm adolescents (≥ 32 weeks) (74 each group). We recorded respiratory symptoms, spirometry and functional echocardiogram. Very preterm adolescents required more respiratory admissions (45.9% vs. 28.4%) (p = 0.03, OR 2.1, CI95% 1.1–4.2) and had more current asthma (21.6% vs. 9.5%, p = 0.04, OR 2.3, CI95% 1.1–5.2). Preterm subjects with intrauterine growth restriction (IUGR) presented lower FEV1 (88.7 ± 13.9 vs. 95.9 ± 13.3, p = 0.027) and lower FVC (88.2 ± 13.6 vs. 95.5 ± 13.3, p = 0.025). When assessing right ventricle, very preterm showed a greater E/E’ ratio (p = 0.02) and longer myocardial performance index (MPI) (p = 0.001). Adolescents with IUGR showed less shortening fraction (p = 0.016), worse E/E′ ratio (p = 0.029) and longer MPI (p = 0.06). Regarding left ventricle, very preterm showed less E′ wave velocity (p = 0.03), greater E/E′ ratio (p = 0.005) and longer MPI (p < 0.001). Gestational age < 32 weeks is independently associated with current asthma in adolescence. Children 13–14 years old born very preterm required more respiratory admissions and had poorer diastolic and global function of both ventricles. IUGR is a risk factor for poorer lung function in preterm adolescents, regardless gestational age.
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1 Severo Ochoa University Hospital, Pediatrics Department, Madrid, Spain (GRID:grid.411361.0) (ISNI:0000 0001 0635 4617); Alfonso X El Sabio University, Madrid, Spain (GRID:grid.464699.0) (ISNI:0000 0001 2323 8386)
2 Alfonso X El Sabio University, Madrid, Spain (GRID:grid.464699.0) (ISNI:0000 0001 2323 8386); La Paz University Hospital, Pediatrics Department, Madrid, Spain (GRID:grid.81821.32) (ISNI:0000 0000 8970 9163); Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain (GRID:grid.81821.32); TEDDY Network (European Network of Excellence for Pediatric Clinical Research), Bari, Italy (GRID:grid.81821.32)
3 Clinico San Carlos University Hospital, Pediatrics Department, Madrid, Spain (GRID:grid.411068.a) (ISNI:0000 0001 0671 5785)
4 Severo Ochoa University Hospital, Pediatrics Department, Madrid, Spain (GRID:grid.411361.0) (ISNI:0000 0001 0635 4617); Alfonso X El Sabio University, Madrid, Spain (GRID:grid.464699.0) (ISNI:0000 0001 2323 8386); Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain (GRID:grid.464699.0)