{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T20:39:06Z","timestamp":1781555946318,"version":"3.54.5"},"reference-count":38,"publisher":"BMJ","issue":"7","funder":[{"name":"Parker B. Francis Fellowship Program","award":["Grant no - NA"],"award-info":[{"award-number":["Grant no - NA"]}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K08HL173625"],"award-info":[{"award-number":["K08HL173625"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL169859"],"award-info":[{"award-number":["R01HL169859"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Environmental Health Sciences of the National Institutes of Health","award":["P30ES013508"],"award-info":[{"award-number":["P30ES013508"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"accepted":{"date-parts":[[2026,3,12]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Lung-function outcomes among preterm-born children referred for pulmonology care are highly heterogeneous, and early determinants remain incompletely defined. We aimed to identify early-life factors associated with school-age lung function after preterm birth and to examine whether school-age spirometry patterns relate to subsequent lung-function trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Early-life analyses (n=511) examined predictors of forced expiratory volume in 1 s (FEV\n                      <jats:sub>1<\/jats:sub>\n                      ) and forced vital capacity (FVC) z-scores at ages 6\u20138 years using multivariable regression. Spirometry-based phenotypes included prematurity-associated preserved-ratio impaired spirometry (pPRISm), prematurity-associated obstructive lung disease (POLD) and prematurity-associated dysanapsis. Longitudinal mixed-effects models assessed lung-function trajectories from ages 8 to 21 years. Parallel analyses were conducted in the National Health and Nutrition Examination Survey (NHANES).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Lower weight-for-height at 4 years was non-linearly associated with both FEV\n                      <jats:sub>1<\/jats:sub>\n                      and FVC at school age. Invasive ventilation in the first year of life was associated with lower FEV\n                      <jats:sub>1<\/jats:sub>\n                      (\u03b2 \u22120.62, 95%\u2009CI \u22120.96 to \u22120.28) and FVC (\u03b2 \u22120.54, 95%\u2009CI \u22120.92 to \u22120.18). In exploratory analyses, pPRISm was inversely associated with neighbourhood income (risk ratio (RR) 0.63 per SD increase, 95%\u2009CI 0.46 to 0.88), and POLD was associated with invasive ventilation (RR 8.07, 95%\u2009CI 3.33 to 19.5). Similar subtypes and associations were observed in NHANES. School-age pPRISm was associated with progressive FEV\n                      <jats:sub>1<\/jats:sub>\n                      z-score decline (age x pPRISm \u03b2 \u22120.08 SD\/year, 95%\u2009CI \u22120.15 to \u22120.02), while POLD was associated with improving FVC z-score (age x POLD \u03b2 0.13 SD\/year, 95%\u2009CI 0.07 to 0.20).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Early-childhood growth, neonatal respiratory exposures and school-age spirometry patterns help stratify long-term pulmonary risk among preterm-born children referred for pulmonary care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/thorax-2026-224740","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T17:20:29Z","timestamp":1775150429000},"page":"679-685","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["School-age lung function after preterm birth: early-life determinants in a paediatric pulmonology cohort with comparison with NHANES"],"prefix":"10.1136","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9186-7547","authenticated-orcid":false,"given":"Jelte","family":"Kelchtermans","sequence":"first","affiliation":[{"name":"University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L","family":"Rice","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna C","family":"Aoyama","sequence":"additional","affiliation":[{"name":"Johns Hopkins Medicine School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2581-4372","authenticated-orcid":false,"given":"Joseph M","family":"Collaco","sequence":"additional","affiliation":[{"name":"Johns Hopkins Medicine School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1576-5394","authenticated-orcid":false,"given":"Sharon","family":"McGrath-Morrow","sequence":"additional","affiliation":[{"name":"University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"2026061502201436000_81.7.679.1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1038\/s41572-019-0127-7","article-title":"Bronchopulmonary dysplasia","volume":"5","author":"Th\u00e9baud","year":"2019","journal-title":"Nat Rev Dis Primers"},{"key":"2026061502201436000_81.7.679.2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1038\/s41372-024-01957-9","article-title":"Long-term pulmonary outcomes in BPD throughout the life-course","volume":"46","author":"Collaco","year":"2026","journal-title":"J Perinatol"},{"key":"2026061502201436000_81.7.679.3","doi-asserted-by":"crossref","DOI":"10.1183\/16000617.0114-2024","article-title":"Impaired lung function and associated risk factors in children born prematurely: a systematic review and meta-analysis","volume":"33","author":"van Boven","year":"2024","journal-title":"Eur Respir Rev"},{"key":"2026061502201436000_81.7.679.4","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202403-244OC"},{"key":"2026061502201436000_81.7.679.5","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1038\/s41390-025-04246-z","article-title":"Lung function in adults born with very low birth weight from young to mid-adulthood","volume":"99","author":"Jussinniemi","year":"2026","journal-title":"Pediatr Res"},{"key":"2026061502201436000_81.7.679.6","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":"2026061502201436000_81.7.679.7","doi-asserted-by":"crossref","DOI":"10.1177\/1753466619892492","article-title":"Bronchopulmonary dysplasia: what are its links to COPD?","volume":"13","author":"McGrath-Morrow","year":"2019","journal-title":"Ther Adv Respir Dis"},{"key":"2026061502201436000_81.7.679.8","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1002\/ppul.25244","article-title":"Predictors of pulmonary function at 6 years of age in infants with bronchopulmonary dysplasia","volume":"56","author":"Aoyama","year":"2021","journal-title":"Pediatr Pulmonol"},{"key":"2026061502201436000_81.7.679.9","doi-asserted-by":"crossref","DOI":"10.1186\/s12931-021-01720-0","article-title":"Lung function trajectories in children with post-prematurity respiratory disease: identifying risk factors for abnormal growth","volume":"22","author":"Levin","year":"2021","journal-title":"Respir Res"},{"key":"2026061502201436000_81.7.679.10","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1164\/rccm.202102-0272OC","article-title":"Increased Impact of Air Pollution on Lung Function in Preterm versus Term Infants: The BILD Study","volume":"205","author":"Decrue","year":"2022","journal-title":"Am J Respir Crit Care Med"},{"key":"2026061502201436000_81.7.679.11","doi-asserted-by":"crossref","DOI":"10.1056\/EVIDoa2200279","article-title":"Lung Function of Preterm Children Parsed by a Polygenic Risk Score for Adult COPD","volume":"2","author":"Nissen","year":"2023","journal-title":"NEJM Evid"},{"key":"2026061502201436000_81.7.679.12","doi-asserted-by":"publisher","DOI":"10.1136\/thorax-2022-219301"},{"key":"2026061502201436000_81.7.679.13","doi-asserted-by":"crossref","DOI":"10.1183\/23120541.00023-2025","article-title":"Preserved ratio impaired spirometry, dysanapsis and airflow obstruction with low forced expiratory volume in 1\u2005s in childhood asthma","volume":"11","author":"Stridsman","year":"2025","journal-title":"ERJ Open Res"},{"key":"2026061502201436000_81.7.679.14","doi-asserted-by":"crossref","first-page":"753","DOI":"10.2147\/COPD.S453086","article-title":"Preserved Ratio Impaired Spirometry (PRISm): A Global Epidemiological Overview, Radiographic Characteristics, Comorbid Associations, and Differentiation from Chronic Obstructive Pulmonary Disease","volume":"19","author":"Huang","year":"2024","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"2026061502201436000_81.7.679.15","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/S2213-2600(25)00372-8","article-title":"Looking beyond bronchopulmonary dysplasia: prematurity-associated lung disease and its phenotypes","volume":"14","author":"Course","year":"2026","journal-title":"Lancet Respir Med"},{"key":"2026061502201436000_81.7.679.16","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/S2213-2600(25)00371-6","article-title":"Trajectories of prematurity-associated lung disease: lifelong lung health","volume":"14","author":"Du Berry","year":"2026","journal-title":"Lancet Respir Med"},{"key":"2026061502201436000_81.7.679.17","unstructured":"National Center for Health Statistics (NCHS) . National health and nutrition examination survey: 2007\u20132008, 2009\u20132010, and 2011\u20132012. Hyattsville (MD) Centers for Disease Control and Prevention (CDC)."},{"key":"2026061502201436000_81.7.679.18","unstructured":"GLF Initiative . Global lung function initiative calculators for spirometry, TLCO and lung volume. n.d. Available: https:\/\/gli-calculator.ersnet.org\/index.html"},{"key":"2026061502201436000_81.7.679.19","doi-asserted-by":"crossref","first-page":"100099","DOI":"10.1016\/j.simpa.2021.100099","article-title":"zipcodeR: Advancing the analysis of spatial data at the ZIP code level in R","volume":"9","author":"Rozzi","year":"2021","journal-title":"Software Impacts"},{"key":"2026061502201436000_81.7.679.20","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.ph.46.030184.003153"},{"key":"2026061502201436000_81.7.679.21","unstructured":"Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS) . CDC growth charts. U.S. Dept of Health & Human Services, CDC; 2024."},{"key":"2026061502201436000_81.7.679.22","unstructured":"RC Team . R: a language and environment for statistical computing. Vienna, Austria R Foundation for Statistical Computing; 2024."},{"key":"2026061502201436000_81.7.679.23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v009.i08","article-title":"Analysis of Complex Survey Samples","volume":"9","author":"Lumley","year":"2004","journal-title":"J Stat Soft"},{"key":"2026061502201436000_81.7.679.24","unstructured":"Lumley T . svyVGAM: design-based inference in vector generalised linear models. Version 1.2-17. 2025."},{"key":"2026061502201436000_81.7.679.25","doi-asserted-by":"crossref","DOI":"10.1093\/database\/baae028","article-title":"nhanesA: achieving transparency and reproducibility in NHANES research","volume":"2024","author":"Ale","year":"2024","journal-title":"Database (Oxford)"},{"key":"2026061502201436000_81.7.679.26","unstructured":"Lytras T . rspiro: Implementation of spirometry equations 0.5. 2024."},{"key":"2026061502201436000_81.7.679.27","unstructured":"Vogel M . childsds: Data and methods around reference values in pediatrics 0.9.11. 2025."},{"key":"2026061502201436000_81.7.679.28","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.10.082"},{"key":"2026061502201436000_81.7.679.29","doi-asserted-by":"crossref","unstructured":"Wu J , Wang G , Gan J , et al . Nomogram to predict progression from preserved ratio impaired spirometry to chronic obstructive pulmonary disease. Sci Rep 2025;15. doi:10.1038\/s41598-025-93359-w","DOI":"10.1038\/s41598-025-93359-w"},{"key":"2026061502201436000_81.7.679.30","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200703-476OC"},{"key":"2026061502201436000_81.7.679.31","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1017\/S1742058X16000205","article-title":"The long-term dynamics of racial\/ethnic inequality in neighborhood air pollution exposure, 1990\u20132009","volume":"13","author":"Kravitz-Wirtz","year":"2016","journal-title":"Du Bois Rev"},{"key":"2026061502201436000_81.7.679.32","doi-asserted-by":"publisher","DOI":"10.1093\/sf\/sot099"},{"key":"2026061502201436000_81.7.679.33","doi-asserted-by":"crossref","DOI":"10.1289\/EHP959","article-title":"Changes in Transportation-Related Air Pollution Exposures by Race-Ethnicity and Socioeconomic Status: Outdoor Nitrogen Dioxide in the United States in 2000 and 2010","volume":"125","author":"Clark","year":"2017","journal-title":"Environ Health Perspect"},{"key":"2026061502201436000_81.7.679.34","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202307-1185OC"},{"key":"2026061502201436000_81.7.679.35","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201508-1706OC"},{"key":"2026061502201436000_81.7.679.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jenvman.2016.03.051"},{"key":"2026061502201436000_81.7.679.37","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1164\/rccm.201506-1058OC","article-title":"Lifetime Exposure to Ambient Pollution and Lung Function in Children","volume":"193","author":"Rice","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"2026061502201436000_81.7.679.38","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201505-0928OC"}],"container-title":["Thorax"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/thorax-2026-224740","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T09:20:37Z","timestamp":1781515237000},"score":1,"resource":{"primary":{"URL":"https:\/\/thorax.bmj.com\/lookup\/doi\/10.1136\/thorax-2026-224740"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,2]]},"references-count":38,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,6,15]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/thorax-2026-224740"],"URL":"https:\/\/doi.org\/10.1136\/thorax-2026-224740","relation":{},"ISSN":["0040-6376","1468-3296"],"issn-type":[{"value":"0040-6376","type":"print"},{"value":"1468-3296","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,2]]}}}