Trajectories of prematurity-associated lung disease: lifelong lung health.

Abstract

Preterm birth is increasingly recognised as adversely influencing lifelong lung function. This Series paper on prematurity-associated lung disease reviews studies reporting longitudinal lung function measurements in individuals who were born preterm. Evidence suggests that preterm birth alters lung function trajectories from early life onwards, with implications for future respiratory morbidity. We propose that this population needs rigorous follow up that should include systematic monitoring of lung function across the lifespan, starting in childhood. Key priorities include understanding risk factors for poor lung function trajectories and moving beyond bronchopulmonary dysplasia alone to establish the phenotype of individuals who were born preterm that are at increased risk of poor trajectory more precisely. Novel approaches, including data-driven analytics and large-scale collaborative studies, will be essential to define phenotypes and trajectories of prematurity-associated lung disease more robustly. Finally, we highlight the need for interventional studies to establish whether adverse lung function trajectories can be stabilised or improved, thereby reducing risk of early chronic obstructive pulmonary disease (ie, diagnosis at age <50 years).