Preterm birth and exercise capacity: what do we currently know?

Frontiers in Pediatrics

Pediatrics

Christopher A. O’Dea¹  Andrew C. Wilson²  Andrew Maiorana³  Elizabeth F. Smith⁴  Michael L. Beaven⁴  Shannon J. Simpson⁴ 

[1] Respiratory Medicine, Perth Children’s Hospital, Perth, WA, Australia;Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia;Respiratory Medicine, Perth Children’s Hospital, Perth, WA, Australia;Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia;School of Allied Health, Curtin University, Perth, WA, Australia;School of Allied Health, Curtin University, Perth, WA, Australia;Department of Allied Health, Fiona Stanley Hospital, Perth, WA, Australia;Wal-yan Respiratory Research Centre, Telethon Kids Institute, Perth, WA, Australia;School of Allied Health, Curtin University, Perth, WA, Australia;

关键词: exercise and lung disease;    bronchopulmonary dysplasia;    pediatric lung disease;    lung physiology;    pediatric exercise physiology;   

DOI  :  10.3389/fped.2023.1222731

 received in 2023-05-15, accepted in 2023-09-12,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectivesThe long-term cardiopulmonary outcomes following preterm birth during the surfactant era remain unclear. Respiratory symptoms, particularly exertional symptoms, are common in preterm children. Therefore, cardiopulmonary exercise testing may provide insights into the pathophysiology driving exertional respiratory symptoms in those born preterm. This review aims to outline the current knowledge of cardiopulmonary exercise testing in the assessment of children born preterm in the surfactant era.DesignThis study is a narrative literature review.MethodsPublished manuscripts concerning the assessment of pulmonary outcomes using cardiopulmonary exercise testing in preterm children (aged <18 years) were reviewed. Search terms related to preterm birth, bronchopulmonary dysplasia, and exercise were entered into electronic databases, including Medline, PubMed, and Google Scholar. Reference lists from included studies were scanned for additional manuscripts.ResultsPreterm children have disrupted lung development with significant structural and functional lung disease and increased respiratory symptoms. The association between these (resting) assessments of respiratory health and exercise capacity is unclear; however, expiratory flow limitation and an altered ventilatory response (rapid, shallow breathing) are seen during exercise. Due to the heterogeneity of participants, treatments, and exercise protocols, the effect of the aforementioned limitations on exercise capacity in children born preterm is conflicting and poorly understood.ConclusionRisk factors for reduced exercise capacity in those born preterm remain poorly understood; however, utilizing cardiopulmonary exercise testing to its full potential, the pathophysiology of exercise limitation in survivors of preterm birth will enhance our understanding of the role exercise may play. The role of exercise interventions in mitigating the risk of chronic disease and premature death following preterm birth has yet to be fully realized and should be a focus of future robust randomized controlled trials.

【 授权许可】

Unknown   
© 2023 O'Dea, Beaven, Wilson, Smith, Maiorana and Simpson.