{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T11:50:52Z","timestamp":1791287452981,"version":"4.1.0"},"reference-count":85,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":278,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Advances in perinatal and neonatal care have markedly improved the survival of extremely preterm infants; however, long\u2010term respiratory outcomes remain a major clinical concern. Preterm birth is increasingly recognized as an early\u2010life determinant of long\u2010term respiratory health, with several individuals exhibiting persistent lung function impairment beyond childhood. We synthesized current evidence on long\u2010term respiratory outcomes across the prematurity spectrum, primarily focusing on spirometric outcomes in extremely preterm infants, while distinguishing these physiological deficits from clinical respiratory morbidities. Longitudinal cohort studies generally demonstrate persistent airflow limitation, with extremely preterm survivors frequently exhibiting forced expiratory volume in 1\u2009s (FEV\n                    <jats:sub>1<\/jats:sub>\n                    ) values 1.0 to 1.5\n                    <jats:italic>z<\/jats:italic>\n                    \u2010scores below term\u2010born peers. These physiological deficits are greater in individuals with bronchopulmonary dysplasia (BPD) history, where FEV\n                    <jats:sub>1<\/jats:sub>\n                    and FEV\n                    <jats:sub>1<\/jats:sub>\n                    \/forced vital capacity\n                    <jats:italic>z<\/jats:italic>\n                    \u2010scores often remain persistently low, ranging between \u22121.5 and \u22122.0 by early adulthood, with evidence of progressive worsening in some cohorts. Evidence regarding temporal trends in lung function is heterogeneous. However, secular trend analysis indicates that although advances in perinatal care have coincided with significant FEV\n                    <jats:sub>1<\/jats:sub>\n                    <jats:italic>z<\/jats:italic>\n                    \u2010score improvements for infants born at 26\u201327\u2009weeks' gestation (e.g., from \u22120.90 to \u22120.39 over a 20\u2010year period), outcomes for those at the limits of viability (22\u201325\u2009weeks) have shown little improvement. Despite substantial progress in neonatal care, long\u2010term respiratory impairment remains common following preterm birth. Establishing risk\u2010stratified, long\u2010term surveillance systems targeting high\u2010risk groups\u2014such as those with extreme prematurity, severe BPD, recurrent infections, or impaired fetal growth\u2014may help characterize trajectories and optimize long\u2010term respiratory health.\n                  <\/jats:p>","DOI":"10.1111\/ped.70562","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T10:54:46Z","timestamp":1791284086000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Lung Function in Extremely Preterm Infants: Evidence, Trajectories, and Clinical Implications"],"prefix":"10.1111","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3148-9892","authenticated-orcid":false,"given":"Katsuya","family":"Hirata","sequence":"first","affiliation":[{"name":"Department of Neonatal Medicine Osaka Women's and Children's Hospital  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.semperi.2021.151476","article-title":"The Changing Face of Neonatal Intensive Care for Infants Born Extremely Preterm (<28\u2009Weeks' Gestation)","volume":"45","author":"Doyle L. 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