Lung function in children born after foetal growth restriction and very preterm birth.

Aims: To assess lung function at early school age in children delivered at very early gestation owing to intrauterine growth restriction and abnormal foetal blood flow (IUGR).

Methods: Spirometry was performed at median age 8.4 (range 6.5-10.7) years in 31 children born preterm with IUGR (PT-IUGR) with a median (range) birth weight (BW) of 650 (395-976) g and median (range) gestational age 27 (24-29) weeks. Control groups were matched for gender and age and had BW appropriate for gestational age (AGA); 31 children born preterm (PT-AGA) with BW of 1010 (660-1790) g matched for gestational age at birth, and 31 children born at term (T-AGA) with BW of 3530 (3000-4390) g.

Results: The PT-IUGR group had lower mean (SD) values of z-scores for FEV(1), FEV(1)/FVC and forced mid-expiratory flow rate (FEF(25-75%)) compared to the T-AGA group, p = 0.003, p = 0.032 and p < 0.001, respectively, but did not differ from the PT-AGA group. PT-IUGR children delivered at ≥26 gestational weeks (GW) had lower FEF(25-75%) than PT-AGA children of corresponding GA, p = 0.014.

Conclusion: Lung function was reduced in the PT-IUGR group at early school age compared to controls born at term. The influence of IUGR on later lung function was only apparent in children born preterm after 26 GW.