1232 Pulmonary Function at Early School Age Following Intrauterine Growth Restriction with Abnormal Fetal Blood Flow and Very Preterm Birth

Background: There is evidence of impaired lung development during childhood following preterm birth. Infants born very preterm due to intrauterine growth restriction (IUGR) and absent or reversed end-diastolic blood flow (ARED) have an increased risk for chronic lung disease (CLD). Objective: To evaluate pulmonary function at early school age in children born at very early gestation due to IUGR and ARED. Methods: Data on self-reported respiratory health and lung function obtained by spirometry were evaluated in 19 children (PT-IUGR) with IUGRARED with a mean (SD) birthweight of 681(125) g born at median (range) 27(24-29) gestational weeks. These were compared with 19 children (PT-AGA) matched for gestational age at birth, gender and time of delivery with a BW appropriate for gestational age at birth (AGA), 1082(298) g and with 19 children (T-AGA) born at term with BW AGA 3647 (465) g matched for gender and time of delivery. Spirometry was recorded at age 7.3 to 10.7 yrs (median 9.0). Results: The PT-IUGR group had lower mean (SD) values of % predicted Forced Expiratory Volume, 1 sec (FEV 1 ) and Forced Expiratory Flow, 25-75% (FEF 25-75 ) compared to the T-AGA group. FEV 1 :85.4 (13.0) and 96.6 (16.1) p=0.046 and FEF 25-75: 67.7 (18.0) and 92.3 (28.5), p=0.006 respectively. The PT-AGA group did not differ from the T-AGA group. Self-reported rate of asthma did not differ between groups. Conclusion: At early school age, pulmonary function is particularly impaired in children born preterm with IUGR-ARED suggesting additional detrimental effect on lung development.