Rationale: Population-based data regarding the consequences of very low birth weight (VLBW) and bronchopulmonary dysplasia (BPD) on adult exercise capacity are limited. Objectives: To compare exercise capacity in a national VLBW cohort with term-born controls and explore factors contributing to the differences. Methods: At 26-30 years of age, 228 VLBW survivors and 100 controls underwent lung function tests, cardiopulmonary exercise testing, and assessment of resting cardiac structure and function using echocardiography. Data on self-reported physical activity were collected. Measurements and Main Results: Compared with controls, adults with VLBW demonstrated reduced oxygen uptake, work rate, and oxygen pulse at peak exercise (9.3%, 10.7%, and 10.8% lower, respectively) and earlier anaerobic threshold (all P < 0.0001), with all mean values within normal range. VLBW survivors showed reduced physical activity, impaired lung function (reduced FEV1, FEV1/FVC, and DlCO), altered left ventricular structure and function (reduced mass, size, stroke volume, and cardiac output), and reduced right atrial and ventricular size. Adjustment for the combination of three sets of covariates (physical activity with body mass index, lung function, and cardiac structure and function) explained most of the exercise group differences. Beyond the effects of physical activity and body mass index, lung function and cardiac structure and function contributed approximately equally. BPD with other prematurity-related perinatal factors (ventilation, antenatal steroids, extremely low birth weight, and extreme preterm) were not associated with a reduced exercise capacity. Conclusions: Exercise capacity was significantly reduced in adults with VLBW, which we speculate is from combined effects of impaired lung function, altered heart structure and function, and reduced physical activity. Perinatal factors including BPD were not associated with a reduced exercise capacity.

中文翻译：

---

出生体重极低的成年人运动能力降低：一项基于人群的队列研究。

基本原理：关于极低出生体重 (VLBW) 和支气管肺发育不良 (BPD) 对成人运动能力的影响的基于人群的数据有限。目的：比较全国 VLBW 队列与足月出生对照组的运动能力，并探讨导致差异的因素。方法：在 26-30 岁时，228 名 VLBW 幸存者和 100 名对照者接受了肺功能测试、心肺运动测试以及使用超声心动图评估静息心脏结构和功能。收集了有关自我报告的身体活动的数据。测量结果和主要结果：与对照组相比，VLBW 成人在运动峰值（分别降低 9.3%、10.7% 和 10.8%）和更早的无氧阈值（所有 P < 0.0001）时表现出摄氧量、工作率和氧脉冲降低, 所有平均值均在正常范围内。VLBW 幸存者表现出身体活动减少、肺功能受损（FEV1、FEV1/FVC 和 DlCO 降低）、左心室结构和功能改变（质量、大小、每搏输出量和心输出量减少），以及右心房和心室大小减少。对三组协变量（身体活动与体重指数、肺功能以及心脏结构和功能）组合的调整解释了大部分运动组的差异。除了身体活动和体重指数的影响之外，肺功能和心脏结构和功能的贡献大致相同。BPD 与其他早产相关围产期因素（通气、产前类固醇、极低出生体重和极早产）与运动能力降低无关。结论：VLBW 成人的运动能力显着降低，我们推测这是由于肺功能受损、心脏结构和功能改变以及体力活动减少的综合影响。包括 BPD 在内的围产期因素与运动能力降低无关。