Preterm Birth And Connections To Lung Disease In Adulthood

I am always interested in studies that look at preterm birth health outcomes in adulthood, especially in regards to asthma. There seems to be a big gray area when I discuss the impacts of my preterm birth on my asthma severity with my care team. The main answer I generally receive from clinicians and researchers is that they are not really sure.

Connections between preterm birth and asthma

Often asthma diagnosis in children is non-specific. Children with impaired lungs may experience some degree of shortness of breath, wheezing, and cough. These symptoms are similar to asthma, however, this does not mean that the child necessarily has asthma.1

The studies found that those born with very low birth weight and both restricted and accelerated fetal growth were predisposed to poorer lung function and respiratory diseases later in life. An increased risk of childhood asthma was also identified. It was indicated that low birth weight affected lung function greater in childhood than in adolescents. This has led to the question: Can babies self-right themselves and do they have a resiliency that helps them overcome the challenges of preterm birth?2

What exactly is airway growth?

I found varying degrees of information and, honestly, not much of it was helpful. I found information that details how the lungs develop rapidly within the first three years of life and by the time children are three they have mini versions of adult lungs.3

It is my understanding that at this age, air sacs then began to get bigger as children grow. The rapid multiplication of air sacs happens earlier in life. There are also reports that children may continue to grow new air sacs throughout childhood, however, more research is needed in this area.3

Where does this leave preemies?

More research is needed. From what I gathered, there are various thresholds, being very preterm and very low birth increases your odds of lower lung function, lower FVC (forced vital capacity) in particular, and poorer respiratory outcomes later in life. It is complex and many factors go into determining risk factors for future lung disease for preemies.3

The other factor to consider is the connection to BPD (bronchopulmonary dysplasia), which is associated with preterm birth for those born before 28 weeks gestational age. It is associated with a risk of asthma later in life and airflow limitation in adults. This is thought to have different risk factors than those preemies without BPD.4

Personally, I feel that the preemie factors are often overlooked in adult diagnoses or connections to risk factors for those in later decades of their life. More information about the effects of my preemie status became apparent in the finding that I have child-size lungs and I am well into adulthood, which was discovered on bronchoscopy. While it was an unusual finding, the doctors did not know what to make of it in regard to its connection to my asthma.

Were you a preterm birth? If so, has your care team mentioned preterm birth connections to your asthma? I would love to hear about your experience.

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