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This study aimed to assess whether C-reactive protein levels during the first 28 days of life predict lung function at five to six years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicentre observational study, infants with a birthweight below 1500 grams and born between 2009 and 2015 were included. A C-reactive protein concentration above 10\u2009mg\/L was considered elevated. Recurrent elevations were defined as at least two values above this threshold separated by 14 days or more, with an interim decrease below 5\u2009mg\/L. Lung function was assessed by spirometry and running endurance at school age. Analyses included univariate tests and linear regression models adjusted for relevant risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Here we show that among 268 infants with a median gestational age of 27.6 (25.7\u201329.4) weeks, those with recurrent C-reactive protein elevations had higher rates of bronchopulmonary dysplasia (56.3% versus 29.4%, p\u2009&lt;\u20090.027) and a greater proportion of children with forced expiratory volume in one second below the fifth percentile (71.9% versus 61.8%, p\u2009&lt;\u20090.001), and reduced running endurance. Recurrent elevations showed a high positive predictive value (71.9%) but low sensitivity (20.2%) for detecting severely reduced lung function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The absence of recurrent C-reactive protein elevations in the neonatal period is associated with better long-term pulmonary outcomes and physical performance. These findings suggest that early inflammatory activity contributes to adverse lung development and support incorporating inflammatory biomarkers into multivariable models for early risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s43856-026-01569-8","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T10:49:20Z","timestamp":1775040560000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Predictive value of increased C-reactive protein levels in preterm infants on respiratory function at five to six years of age"],"prefix":"10.1038","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1676-8340","authenticated-orcid":false,"given":"Mats Ingmar","family":"Fortmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Dappen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Roll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Kozhuharova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"von der Wense","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"H\u00e4rtel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Sandk\u00f6tter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Egbert","family":"Herting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"G\u00f6pel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1226-0016","authenticated-orcid":false,"given":"Alexander","family":"Humberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"1569_CR1","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1055\/s-0035-1571202","volume":"33","author":"R Patel","year":"2016","unstructured":"Patel, R. 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