Background It is unknown if adults born <28 weeks or <1000 g since surfactant has been available are reaching their full airway growth potential. Objective To compare expiratory airflow at 25 years and from 8 to 25 years of participants born <28 weeks or <1000 g with controls, and within the preterm group to compare those who had bronchopulmonary dysplasia with those who did not. Methods All survivors born <28 weeks or <1000 g in 1991–1992 in Victoria, Australia, were eligible. Controls were born contemporaneously, weighing >2499 g. At 8, 18 and 25 years, expiratory airflows were measured and the results converted to z-scores. Outcomes were compared between groups at age 25 years, and trajectories (change in z-scores per year) from childhood were contrasted between groups. Results Expiratory airflows were measured at 25 years on 164 of 297 (55%) preterm survivors and 130 of 260 (50%) controls. Preterm participants had substantially reduced airflow compared with controls at age 25 years (eg, zFEV1; mean difference −0.97, 95% CI −1.23 to –0.71; p<0.001). Preterm participants had lower airflow trajectories than controls between 8 and 18 years, but not between 18 and 25 years. Within the preterm group, those who had bronchopulmonary dysplasia had worse airflows and trajectories than those who did not. Conclusions Young adults born <28 weeks or <1000 g in the surfactant era, particularly those who had bronchopulmonary dysplasia, have substantially reduced airway function compared with controls. Some are destined to develop COPD in later adult life.

中文翻译：

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在后表面活性剂时代出生极早产或极低出生体重的年轻人的气道阻塞

背景 目前尚不清楚出生 <28 周或 <1000 g 的成年人是否在表面活性剂可用后达到其气道生长潜力。目的 比较出生 <28 周或 <1000 g 的参与者在 25 岁和 8 至 25 岁时与对照组的呼气气流，以及在早产组中比较患有支气管肺发育不良的人和没有患有支气管肺发育不良的人。方法 1991-1992 年在澳大利亚维多利亚出生 <28 周或 <1000 g 的所有幸存者都符合条件。对照组同时出生，体重 > 2499 g。在 8、18 和 25 岁时，测量呼气气流并将结果转换为 z 分数。在 25 岁时比较各组之间的结果，并在各组之间对比儿童时期的轨迹（每年 z 分数的变化）。结果 在 25 年时对 297 名 (55%) 早产幸存者中的 164 名和 260 名 (50%) 对照组中的 130 名进行了呼气气流测量。与对照组相比，早产参与者在 25 岁时的气流显着减少（例如，zFEV1；平均差异 -0.97，95% CI -1.23 至 –0.71；p<0.001）。早产参与者在 8 至 18 岁之间的气流轨迹低于对照组，但在 18 至 25 岁之间则不然。在早产组中，那些患有支气管肺发育不良的人比那些没有的人的气流和轨迹更差。结论 在表面活性剂时代出生 <28 周或 <1000 g 的年轻人，特别是那些患有支气管肺发育不良的年轻人，与对照组相比，其气道功能显着降低。有些人注定会在成年后期发展为 COPD。