Kouroukli E; Aristotle University of Thessaloniki, Thessaloniki, Greece.
Sarafidis K; Tsanakas J; Hatziagorou E

Pediatric Pulmonology. 61(2):e71492, 2026 Feb.

BACKGROUND: Bronchopulmonary dysplasia is one of the most common
complications of preterm birth and has lifelong repercussions in
respiratory health.

OBJECTIVE: To examine lung function and exercise capacity and assess
potential differences in exertional respiratory pattern and ventilatory
and gas exchange responses in school-aged children with a history of
prematurity and/or BPD.

METHODS: Prospective observational study including children and
adolescents born preterm, with and without BPD, and healthy term-born
controls without a known history of asthma. Participants performed
spirometry and cardiopulmonary exercise testing.

RESULTS: Eighty-two children aged 6-18 years (mean: 11.9 years, SD: 3.1)
were enrolled and examined in three groups: preterm-born with BPD
(gestational age < 32 weeks), preterm-born without BPD (GA < 37 weeks),
and term-born controls (GA >= 37 weeks). FVC, FEV1, FEF25% -75%, and
FEV1/FVC were normal and comparable among the three groups. VO2peak% was
reduced in the BPD group and was significantly lower than the control
group (mean difference: -14.4, CI: -28 to -0.7, adjusted p = 0.04), but
the difference was not significant when adjusting for height. The BPD
group had the highest mean VE/VCO2 adjusted for height (32.7), followed by
the preterm (30.3) and the control group (29.5), and the difference
between the BPD and control group was statistically significant (p =
0.015). Moreover, BPD status was significantly associated with increased
VE/VCO2 (beta = +3.2, CI: 1-5.4, p = 0.005). The rest of the CPET
parameters were within normal limits and comparable among groups.

CONCLUSIONS: Children with BPD have normal lung function but reduced
exercise capacity and decreased ventilatory efficiency during exercise.