NICU Follow Up and Neurodevelopment 4: Very Long and Long Term Follow-Up
138 - Clinical characteristics of VLBW preterm children compared to full-term at school age
Sunday, April 30, 2023
3:30 PM – 6:00 PM ET
Poster Number: 138 Publication Number: 138.362
Rita C. Silveira, HCPA/UFRGS, Porto Alegre, Rio Grande do Sul, Brazil; Rafael O. Fernandes, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil; Renato S. Procianoy, Universidade Federal do Rio Grande do Sul and Hospital de clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
FULL PROFESSOR, HEAD OF NICU HCPA/UFRGS Porto Alegre, Rio Grande do Sul, Brazil
Background: Preterm infants have a high risk of early cardiovascular events and early onset chronic diseases when compared to children born full-term. The risk of premature death has increased by 40% in young adults born preterm Objective: To compare clinical characteristics and muscle strength in very low birth weight preterm to full term at school age Design/Methods: A cohort of inborn preterm children ≤32 weeks GA (PTM group) born between 2008-2013 followed-up by the institutional follow-up clinic. Full-term inborn children from the same institution were recruited as a Control. Clinical exam, body composition, blood pressure (automated), lung function (Datospir Micro C) and maximal Inspiratory Pressure (IPmax)(analogic manovacuometer Murenas) were assessed. Groups were compared by t-test, analysis of covariance, and Pearson’ correlation. The study was approved by the Institutional Ethics Committee. Results: 65 PTM children (29 boys/36 girls, 11±1 y-o, 145±9 cm, median BMI 17.6) were significantly smaller and lighter when compared to 32 full-term children (19 boys/13 girls, 11±1 y-o, 150±9 cm, BMI 19.6). 29% PTM vs. 47% term (p=0.05) had overweight and obesity. Fat-free mass (FFM) was reduced in PTM (30.1±5.6Kg) vs. Term (33.8±7.1), p=0.008. Only PTM presented arterial hypertension ( >p95 in 14%,). Lung function was reduced in PTM vs. Term (z-score: FEV1 -0.02±1.2 vs. 0.81±1.1 (p=0.01); FVC 0.03±1.1 vs. 0.48±1.1 (p=0.121); FEV1/FVC -0.11±1.0 vs. 0.49±0.7 (p=0.01) and only PTM presented values under the low limit of normality (17% (n=10), p=0.05). Maximal hand grip strength was reduced in PTM (15.4±4.6 Kg) vs. Term (17.6±4.5 Kg), p=0.008 (adjusted by FFM: p=0.122). IPmax was reduced in PTM (-77±23cmH2O) vs. Term (-90±19), p=0.01 (adjusted by FFM: p=0.07). Only PTM group presented significant association of IPmax with FEV1 (liters) (r=-0.47, p=0.001), FVC (liters) (r=-0.47, p=0.001) and hand grip (r=-0.42, p=0.001). Bronchopulmonary dysplasia (n=13) was associated with reduced FVC z-score (p=0.05), and PIVH/leukomalacia (n=18) was associated with reduced hand grip strength (p=0.01)
Conclusion(s): VLBW preterm children at school age presented a vulnerability package in compared to term children at school age. To implement preventive strategies is critical to stablish better outcomes in this vulnerable population
