According to a recent study published in the Annals of the American Thoracic Society, adults born very or extremely preterm have respiratory limitations to exercise similar to patients with chronic obstructive pulmonary disease, similar to healthy elderly or casual smokers by the time they reach their early 20s.

The study, led by Andrew T. Lovering, a professor of human physiology at the University of Oregon, found that premature infants are at higher risk for contracting bronchopulmonary dysplasia, (BPD) a chronic respiratory disease that affects preterm infants who receive oxygen therapy. The higher the levels of oxygen, and also the increased pressure from the ventilator, higher the lung tissue scarring and other complications.

These infants have been found to be at increased risk for chronic obstructive pulmonary disease, a progressive disease that affects breathing. COPD affects 329 million people worldwide and is often the result of exposure to air pollution or smoking.

In this new study, the researchers tested the hypothesis that adult survivors of preterm birth (≤32 wk gestational age) with (n = 20) and without BPD (n = 15) with reduced exercise capacity would demonstrate clinically important respiratory limitations at near-maximal exercise compared with full-term control subjects (n = 20).

Results indicated that adults survivors of preterm birth without BPD, like their counterparts with BPD, have symptoms of mild COPD in their mid-20s, as their lungs functioned less efficiently in comparison to the control group.

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“We were expecting more variation between the two preterm groups — with and without BPD,” Lovering said in a news release. “We didn’t anticipate that they would share a similar lung profile.”

As Lovering mentioned, even if the lung function decline rates remain normal throughout their life, adult preterm survivors with COPD are prone to developing respiratory complications at a much younger age, and also to develop fatigue and poor exercise capacity, resulting in reduced quality of life.

In terms of clinical management of these patients, Lovering mentioned that only some doctors usually ask about the neonatal period when treating their patients, so preterm adults often receive a misguided diagnosis of asthma.

“Additional research is needed to find better ways to serve adult survivors of preterm birth,” Lovering said. “We need to better understand how we can help them maximize their quality of life and lung health as they age.”