Preemies Aren't Little Term Babies

Disorders of feeding and swallowing, and the risk of aspiration are increased in premie infants.  This study highlights that a routine surgery performed for a common pediatric disorder known as as laryngomalacia (floppy airway) may significantly raise risk for aspiration more so than in term infants. Dr. Susarla

The effects of prematurity on incidence of aspiration following supraglottoplasty for laryngomalacia.

Abstract

OBJECTIVES:

To determine if patients who were born premature have a higher incidence of aspiration following supraglottoplasty compared to patients born full term.

STUDY DESIGN:

Retrospective study.

METHODS:

Two thousand three hundred sixty (2360) patient charts from Riley Hospital for Children were reviewed retrospectively. Patients had already been treated for laryngomalacia with supraglottoplasty by Dr. Bruce Matt. Estimated weeks gestational age at birth was recorded for each patient. Prematurity was stratified as mild (32-36 weeks gestational age [WGA]), very (28-31 WGA), or extremely (<28 WGA). Patients were excluded from the study if they had suspected aspiration with chronic cough, pneumonia, chronic lung disease, or documented aspiration prior to supraglottoplasty.

RESULTS:

As previously shown, 75 patients (3.2%) had aspiration following supraglottoplasty. Twenty of these patients were preterm infants at birth. The rate for aspiration following supraglottoplasty for former premature infants was statistically significant (5.9%, odds ratio = 2.3, P = .0032).

CONCLUSIONS:

Children who were born premature have a higher rate of postoperative aspiration following supraglottoplasty; however, supraglottoplasty should still be considered as treatment for laryngomalacia as the rate is still relatively low (5.9%).

Abstract linked here.

Lung function changes seen in later childhood in premature infants

Children with history of bronchopulmonary dysplasia, also commonly referred to as chronic lung disease have increased risk for respiratory symptoms in later childhood.  This seems to correlate with lung function changes that can be measured with simple non-invasive office testing. Dr. Susarla

Pulmonary Outcome in Former Preterm, Very Low Birth Weight Children with Bronchopulmonary Dysplasia: A Case-Control Follow-Up at School Age.

Maike Hove, Freerk Prenzel, Holm H Uhlig, Eva Tillig

OBJECTIVE:

To assess and compare long-term pulmonary outcomes in former preterm-born, very low birth weight (VLBW) children with and without bronchopulmonary dysplasia (BPD) born in the surfactant era.

STUDY DESIGN:

Pulmonary function tests (ie, spirometry, body plethysmography, and gas transfer testing) were performed in children with a history of VLBW and BPD (n = 28) and compared with a matched preterm-born VLBW control group (n = 28). Medical history was evaluated by questionnaire.

RESULTS:

At time of follow-up (mean age, 9.5 years), respiratory symptoms (36% vs 8%) and receipt of asthma medication (21% vs 0%) were significantly more frequent in the preterm-born children with previous BPD than in those with no history of BPD. The children with a history of BPD had significantly lower values for forced expiratory volume in 1 second (z-score -1.27 vs -0.4; P = .008), forced vital capacity (z-score -1.39 vs -0.71 z-score; P = .022), and forced expiratory flow rate at 50% of forced vital capacity (z-score -2.21 vs -1.04; P = .048) compared with the preterm control group.

CONCLUSION:

Preterm-born children with a history of BPD are significantly more likely to have lung function abnormalities, such as airway obstruction and respiratory symptoms, at school age compared with preterm-born children without BPD.

Read article here.

Turmeric Component Can Prevent Lung Damage in Premature Babies

Perhaps another nod to medicine through better nutrition, curcumin is a known potent antioxidant found in turmeric.  Oxidative injury is thought toplay a major role in bronchopulmonary dysplasia, a chronic lung condition affecting premature infants. Dr Susarla

Turmeric Component Can Prevent Lung Damage in Premature Babies

• A component found in turmeric can prevent lung damage in premature babies, a new study says.
  Babies born before 37 weeks of gestational age are considered to be premature babies. Though most of the internal systems of an unborn baby develop by 32 weeks, according to health experts, lungs remain immature at eight month of pregnancy and take more time to fully develop.
  So when babies are born before completing their gestational age, their lungs are not  fully developed. They require ventilation support and oxygen therapy. However, the therapies have long been found to increase the risk of lung damage, a condition known as bronchopulmonary dysplasia (BPD).  The condition is often accompanied by fluid in lungs and scarring. According to the American Lung Association, between 5,000 and 10,000 babies are affected with BPD every year. 
  The study reported in the American Journal of Physiology, Lung Cellular and Molecular Physiology, found a component in turmeric, known as curcumin, effective in protecting babies against the risk of the lung damage (BPD) and hyperoxia- a condition that is caused by excess oxygen in the body.  Premature babies often suffer from this condition nearly 21 days after birth.  
  The findings are based on the experiments conducted by a team of researchers from Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed), with the help of disease models.
  "This is the first study to find long-term benefits of using curcumin to protect lung function in premature infants," Virender K. Rehan, author of the study, said in a news release. "Curcumin is known to have potent antioxidant, anti-inflammatory and anti-microbial properties, making it a promising therapy for premature infants who require oxygen therapy after birth."
  Preterm birth is the leading cause of newborn deaths and the second leading cause of death among children aged below 5 in the world. In the U.S. more than half a million babies are born prematurely. Apart from BPD, premature babies are affected by a series of health problems, including apnea; respiratory distress syndrome; jaundice; anemia; problems related to intestines (Necrotizing enterocolitis -NEC) and infections, particularly to lungs, blood, brain and spinal cord.
  Read article here.