Medical interventions such as mechanical ventilation, high oxygen concentrations, intravenous nutrition and other means of aggressive medical support have positively changed the survival rates for premature infants. Studies have shown that preterm birth and the necessary intensive treatments associated with it place children at increased risk of neurodevelopmental delay, but do they have altered functional exercise capacity as they get older?

That is what Children’s Mercy researchers are looking at in a new study led by Neonatology Division Director Howard Kilbride, MD, in collaboration with the Cardiology Section and the Pulmonology Division. The new study examines the fitness and lung function in children eight years of age and older with birthweights under 800 grams, utilizing treadmill testing to determine oxygen used and carbon dioxide released. The team is assessing variables such as time on a ventilator as a newborn or prolonged use of oxygen that may predict which children are at risk for later difficulties.

“We anticipate that this study will provide a basis for better predicting which children are at risk for later respiratory dysfunction, and also provide a framework upon which to design other studies of interventions that could improve pulmonary outcome and exercise ability in this group of children,“ says Dr. Kilbride.

Children’s Mercy was one of first institutions to scientifically verify that low birthweight, premature newborns are at risk for long-term pulmonary deficits. That research, led by Dr. Kilbride, found that older children and adolescents who are survivors of extreme prematurity had lower maximal mid-expiratory flow and peak expiratory flow rates and lower aerobic capacity compared to a control group. Twenty percent of the survivors of the extreme prematurity group had clinically abnormal pulmonary function.

"Previously, there was a surprising lack of information on this. We wanted hard data and as much information as we could get on what led to the deficits,” says Rich Sabath, EdD, Exercise Physiologist and collaborator on the studies. “We wanted to document the effects into early and mid adolescence so we could tell other parents what to expect based on the children we have evaluated.”