{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:04:38Z","timestamp":1780581878353,"version":"3.54.1"},"reference-count":17,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"unspecified","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020265","name":"Stan Perron Charitable Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1073301"],"award-info":[{"award-number":["APP1073301"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1138605"],"award-info":[{"award-number":["APP1138605"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP634519"],"award-info":[{"award-number":["APP634519"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010289","name":"Princess Margaret Hospital Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010289","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Curtin University"},{"name":"Raine Medical Foundation"},{"name":"The Kids Research Institute Australia"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Resp Res"],"accepted":{"date-parts":[[2026,5,2]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To better characterise prematurity-associated lung disease, adult spirometry phenotype classifications (obstructive lung disease, preserved ratio impaired spirometry and dysanapsis) have been applied to children born preterm. It is unknown how these phenotypes track over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Apply spirometry phenotype classifications to a longitudinal cohort born very preterm (\u226432 weeks gestation) and track changes in classifications from early childhood to adolescence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective longitudinal cohort study included children born very preterm in Western Australia between 1997 and 2003, followed up between 2007 and 2022. Spirometry testing and a modified International Study of Asthma and Allergies in Childhood questionnaire were completed at early childhood (4\u20138 years), middle childhood (9\u201312 years) and adolescence (16\u201323 years). Spirometry phenotype classifications were applied to each participant with acceptable spirometry at each time point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      200 participants completed 311 acceptable spirometry measurements. Abnormal spirometry phenotypes were observed in 29% of participants at early childhood, 41% at middle childhood and 43% at adolescence. Of those with spirometry measurements across at least two time points, 36% changed phenotypes (e.g. from normal to abnormal, from abnormal to normal or changed between the abnormal groups). Many of those that changed phenotype classification had a forced expiratory volume in 1 s (FEV\n                      <jats:sub>1<\/jats:sub>\n                      ) z-score or FEV\n                      <jats:sub>1<\/jats:sub>\n                      to forced vital capacity (FVC) ratio z-score sitting near the lower limits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>It remains unclear whether changes in phenotype reflects the biological variability of the measure or disease progression. The instability of adult spirometry classifications across serial spirometry measurements suggests this approach does not adequately capture the complexity of prematurity-associated lung disease during the growth period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjresp-2025-004041","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:10:16Z","timestamp":1780578616000},"page":"e004041","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Applying spirometry phenotypes to a longitudinal cohort born very preterm"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2696-1398","authenticated-orcid":false,"given":"Tiffany K","family":"Bradshaw","sequence":"first","affiliation":[{"name":"Wal-yan Respiratory Research Centre, Foundations of Lung Disease, The Kids Research Institute Australia, Perth, Western Australia, Australia"},{"name":"School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7931-8051","authenticated-orcid":false,"given":"Sanja","family":"Stanojevic","sequence":"additional","affiliation":[{"name":"Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon J","family":"Simpson","sequence":"additional","affiliation":[{"name":"Wal-yan Respiratory Research Centre, Foundations of Lung Disease, The Kids Research Institute Australia, Perth, Western Australia, Australia"},{"name":"School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"2026060406101258000_13.1.e004041.1","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S2213-2600(23)00272-2","article-title":"Unravelling the respiratory health path across the lifespan for survivors of preterm birth","volume":"12","author":"Simpson","year":"2024","journal-title":"Lancet Respir Med"},{"key":"2026060406101258000_13.1.e004041.2","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.01763-2022","article-title":"Preterm birth and asthma and COPD in adulthood: a nationwide register study from two Nordic countries","volume":"61","author":"Pulakka","year":"2023","journal-title":"Eur Respir J"},{"key":"2026060406101258000_13.1.e004041.3","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/S2213-2600(21)00508-7","article-title":"Association between very to moderate preterm births, lung function deficits, and COPD at age 53 years: analysis of a prospective cohort study","volume":"10","author":"Bui","year":"2022","journal-title":"Lancet Respir Med"},{"key":"2026060406101258000_13.1.e004041.4","doi-asserted-by":"crossref","DOI":"10.1183\/13993003.00239-2023","article-title":"Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary","volume":"61","author":"Agust\u00ed","year":"2023","journal-title":"Eur Respir J"},{"key":"2026060406101258000_13.1.e004041.5","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202102-0517OC"},{"key":"2026060406101258000_13.1.e004041.6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201101-0021OC"},{"key":"2026060406101258000_13.1.e004041.7","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1164\/rccm.202306-1120PP","article-title":"Dysanapsis as a determinant of lung function in development and disease","volume":"208","author":"McGinn","year":"2023","journal-title":"Am J Respir Crit Care 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