Lung Growth and Development

 Lung Growth and Development after very Preterm Birth. Jobe, A. Am J Respir & Critical Care Med (2002); 166; 1529-1530.

 A letter to the editor from Monika Gappa (Germany), Janet Stocks (UK), Peter Merkus (Netherlands). They agreed with Dr. Jobe’s editorial which proposed that the relative reduction in airway function during the first year of life in preterm infants recovering from chronic lung disease of prematurity, might represent the additive adverse effects of very preterm birth plus BPD. Airway function may deteriorate during the first year of life in infants born prematurely in the absence of any neonatal disease or therapy.  See figure # 1

Figure #1 suggest a similar decrement in airway function at one year of age, irrespective of prior disease severity or mode of treatment.

 Mechanisms underlying these observations remain speculative, but may include the fact that maturation dimensional growth and alveolar septation occur out of phase following preterm delivery. Thereby resulting in airways that are more compliant, smaller and/or have fewer alveolar attachments.

 This adds concern to the possibility that chronic lung disease of prematurity, maybe associated with subsequent chronic obstructive pulmonary disease in later life.

In conclusion, there is growing evidence that reduced lung and airway function following preterm delivery. Maybe related to developmental changes as much as to initial disease severity or to treatment effects.

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 Comment: We have all seen this in our practices. Let’s hope, as neonatal patients age, that our internal medicine colleagues do not also.  E.V.