# Lung Function in a Multiethnic U.S. Cohort of Adolescents and Adults Born Preterm in the New BPD Era

## TL;DR

This study finds that adults born preterm, especially non-Hispanic Black individuals, are more likely to have lung function issues compared to those born at term.

## Contribution

The study provides new insights into lung function in a multiethnic U.S. cohort of preterm-born individuals in the modern BPD era.

## Key findings

- Preterm participants were more likely to have obstructive or restrictive ventilatory defects compared to term participants.
- Non-Hispanic Black preterm participants had worse lung function than Hispanic White preterm participants.
- Neonatal factors like bronchopulmonary dysplasia and low weight for gestational age were linked to reduced lung function.

## Abstract

Extreme preterm birth is a recognized risk factor for reduced pulmonary function over the lifespan. However, data are lacking in U.S.‐born adults and in multiethnic populations.

To comprehensively evaluate lung function in adolescents and young adults born premature, and to assess for potential impact of neonatal, racial/ethnic, and socioeconomic risk factors on long‐term lung function.

Preterm participants aged 12–40 years of age were recruited from the Parkland Hospital Neonatal ICU Registry (Dallas County, Texas). Preterm and term‐born participants completed pulmonary function testing including spirometry, lung volumes, diffusion capacity, and respiratory muscle forces, using Global Lung Initiative race‐neutral reference equations. Influence of racial/ethnic background, neonatal factors, and socioeconomic ratings were assessed for preterm participants.

Preterm participants (n = 105; gestational age 29.5 ± 2.5 weeks; current age 26 ± 6 yrs) were significantly more likely than term participants (n = 48; gestational age 39.2 ± 1.1 weeks; current age 29 ± 7 yrs) to have an obstructive or restrictive ventilatory defect (34.4% vs 14.6%, OR 3.06, 95% CI 1.26–7.93), reduced diffusion capacity (16.4% vs 2.1%, OR 9.18, 95% CI 1.47–98.3), and impaired respiratory muscle strength (27.7% vs 4.4%, OR 8.22, 95% CI 2.10–36.2). Neonatal risk factors included history of bronchopulmonary dysplasia and lower weight for gestational age percentile. Lung function was worse in preterm‐born Non‐Hispanic Black participants compared to preterm‐born Hispanic White participants, which could not be explained by available neonatal or socioeconomic factors.

While most moderately to extremely preterm‐born individuals have normal lung function, obstructive and restrictive ventilatory defects, reduced diffusion capacity, and impaired respiratory muscle strength are common.