Sports Medicine ( IF 9.3 ) Pub Date : 2022-06-27 , DOI: 10.1007/s40279-022-01710-2 Thomas Gostelow 1 , Eric J Stöhr 2, 3
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Background
A negative impact of premature birth on health in adulthood is well established. However, it is not clear whether healthy adults who were born prematurely but have similar physical activity levels compared to adults born at term have a reduced maximal aerobic exercise capacity (maximum oxygen consumption [VO2max]).
Objective
We aimed to determine the effect of premature birth on aerobic exercise capacity and lung function in otherwise healthy, physically active individuals.
Methods
A broad literature search was conducted in the PubMed database. Search terms included ‘preterm/premature birth’ and ‘aerobic exercise capacity’. Maximal oxygen consumption (mL/kg/min) was the main variable required for inclusion, and amongst those investigations forced expiratory volume in 1 s (FEV1, % predicted) was evaluated as a secondary parameter. For the systematic review, 29 eligible articles were identified. Importantly, for the meta-analysis, only studies which reported similar activity levels between healthy controls and the preterm group/s were included, resulting in 11 articles for the VO2max analysis (total n = 688, n = 333 preterm and n = 355 controls) and six articles for the FEV1 analysis (total n = 296, n = 147 preterm and n = 149 controls). Data were analysed using Review Manager ( Review Manager. RevMan version 5.4 software. The Cochrane Collaboration; 2020.).
Results
The systematic review highlighted the broad biological impact of premature birth. While the current literature tends to suggest that there may be a negative impact of premature birth on both VO2max and FEV1, several studies did not control for the potential influence of differing physical activity levels between study groups, thus justifying a focused meta-analysis of selected studies. Our meta-analysis strongly suggests that prematurely born humans who are otherwise healthy do have a reduced VO2max (mean difference: − 4.40 [95% confidence interval − 6.02, − 2.78] mL/kg/min, p < 0.00001, test for overall effect: Z = 5.32) and FEV1 (mean difference − 9.22 [95% confidence interval − 13.54, − 4.89] % predicted, p < 0.0001, test for overall effect: Z = 4.18) independent of physical activity levels.
Conclusions
Whilst the current literature contains mixed findings on the effects of premature birth on VO2max and FEV1, our focused meta-analysis suggests that even when physical activity levels are similar, there is a clear reduction in VO2max and FEV1 in adults born prematurely. Therefore, future studies should carefully investigate the underlying determinants of the reduced VO2max and FEV1 in humans born preterm, and develop strategies to improve their maximal aerobic capacity and lung function beyond physical activity interventions.
中文翻译：
早产对健康成人最大有氧运动能力和肺功能的影响：系统评价和荟萃分析
背景
早产对成年后健康的负面影响是众所周知的。然而，尚不清楚早产但与足月出生的成年人具有相似体力活动水平的健康成年人的最大有氧运动能力（最大耗氧量[ V O 2 max] ）是否降低。
客观的
我们的目的是确定早产对健康、身体活跃的个体的有氧运动能力和肺功能的影响。
方法
在 PubMed 数据库中进行了广泛的文献检索。搜索词包括“早产/早产”和“有氧运动能力”。最大耗氧量 (mL/kg/min) 是纳入所需的主要变量，在这些研究中，1 秒用力呼气量（FEV 1，% 预测）被评估为次要参数。对于系统评价，确定了 29 篇符合条件的文章。重要的是，对于荟萃分析，仅纳入了报告健康对照组和早产组之间相似活动水平的研究，从而产生了 11 篇用于 V O 2 max分析的文章（总计n = 688、n = 333 早产儿和n = 355 名对照）和 6 篇 FEV 1分析文章（总计n = 296、n = 147 名早产者和n = 149 名对照）。使用 Review Manager（Review Manager。RevMan 5.4 版软件。Cochrane Collaboration；2020。）对数据进行分析。
结果
系统评价强调了早产的广泛生物学影响。虽然目前的文献倾向于表明早产可能对V O 2 max 和 FEV 1都有负面影响，但一些研究并未控制研究组之间不同体力活动水平的潜在影响，因此证明了有针对性的荟萃分析的合理性。 -所选研究的分析。我们的荟萃分析强烈表明，健康的早产儿的V O 2 max确实降低（平均差：− 4.40 [95% 置信区间 − 6.02，− 2.78] mL/kg/min，p < 0.00001，测试总体效果：Z = 5.32）和 FEV 1（平均差 − 9.22 [95% 置信区间 − 13.54，− 4.89]% 预测，p < 0.0001，总体效果检验：Z = 4.18）独立于体力活动水平。
结论
虽然当前文献关于早产对V O 2 max 和 FEV 1影响的研究结果不一，但我们的重点荟萃分析表明，即使体力活动水平相似，V O 2 max 和 FEV 1也会明显降低在早产的成年人中。因此，未来的研究应仔细研究早产儿中VO 2 max 和FEV 1降低的根本决定因素，并制定除体力活动干预之外提高其最大有氧能力和肺功能的策略。
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