Impact of moderate to late preterm birth on 5 year lung function in a South African birth cohort

Introduction: Prematurity is associated with impaired lung growth and increased respiratory morbidity in childhood. Data from low and middle income settings are lacking. Aim: To investigate the impact of preterm birth on lung function at 5 years in a South African birth cohort, Drakenstein Child Health Study. Methods: Moderate to late preterm(32-37 weeks gestation) and term(>37weeks GA)infants with lung function at 5 years were included. Measurements included oscillometry, tidal breathing analysis(TBA) and multiple breath washout(MBW).Infants born <32 weeks GA or HIV infected were excluded. Regression analysis adjusted for height for age z-score (HAZ) was used to compare the groups. Results: 708 children(47.7% female)were included;95(13.4%)preterm and 613(86.6%)term;mean(SD)GA 34.6 wks(1.4) and 39.3(1.5), HAZ -0.88(1.26) and -0.65(1.03) respectively. At 5 years, preterm born children had increased resistance and decreased compliance compared to term children. No difference in TBA and MBW outcomes were noted:Table Conclusion: Children born late preterm have changes in respiratory mechanics at 5 years, but similar lung volumes compared to term born. This may contribute to susceptibility to respiratory illness. Funding: Gates FoundationOPP1017641, Wellcome Trust204755/Z/162, ERS CRC Award(CRC-2013-02, INCIRCLE), Hungarian Scientific Research Fund(#105403#128701)