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Research Article: A study on differences in lung function development and longitudinal patterns between preterm infants of different gestational ages and term infants

Date Published: 2026-06-23

Abstract:
To address gaps in small airway function follow-up and grouping criteria for extremely preterm infants, this study adopted dual grouping to explore baseline differences and longitudinal pulmonary function patterns between preterm (by gestational age: <?32 weeks, 32–33?+?6 weeks, 34–36?+?6 weeks) and term (??37 weeks) infants. It aimed to clarify impacts of gestational age, birth weight, and other factors, providing evidence for individualized clinical follow-up and intervention. From 2020 to 2024, 113 term-equivalent infants from Guangyuan Central Hospital were enrolled. Lung function parameters (VT, TPEF/TE, TEF50, etc.) at corrected 40 weeks (0 months), 3 and 6 months, plus perinatal data were collected. Inter-group differences were analyzed via ANOVA/Kruskal–Wallis tests, baseline factors via linear regression, longitudinal change rates via linear mixed models (LMM), and intra-group recovery via repeated-measures ANOVA. At baseline, lower gestational age correlated with reduced VT, TPEF/TE, VPEF/VE, and elevated RR ( P <?0.05); the <?32 weeks group had significantly lower VT (20.4?+?4.6?mL) vs.???37 weeks (24.6?+?3.1?mL, P <?0.001). At 3 months, <?32 weeks infants had higher VT (51.6?+?8.3?mL) than 34–36?+?6 weeks (39.5?+?9.2?mL, P =?0.001). At 6 months, only TEF50 in <?32 weeks group (84.2?+?17.6?mL/s) remained lower vs.???37 weeks (75.1?+?19.7?mL/s, P <?0.05). LMM showed each additional week of gestational age increased VT by 0.15?mL/month ( P =?0.017)); <?32 weeks group had faster VT growth (0.23?mL/month) than ??37 weeks (0.09?mL/month, P <?0.05). Each 1?kg higher birth weight increased VT by 0.75?mL/month ( P =?0.003); maternal gestational diabetes accelerated VT growth ( ? =?1.04?mL/month P =?0.025). Preterm infants exhibit gestational age-dependent compensatory lung function recovery, with faster rates in younger gestational ages. However, extremely preterm infants (<?32 weeks) infants (<?32 weeks) have delayed small airway function (TEF50) at 6 months. Gestational age, birth weight, and maternal gestational diabetes are key factors. Clinicians should implement individualized 3-monthly small airway function monitoring for <?32 weeks infants to reduce long-term respiratory disease risk.

Introduction:
Preterm infants exhibit significantly elevated risks of long-term respiratory diseases (e.g., chronic obstructive pulmonary disease and recurrent wheezing) in comparison to term infants, attributable to incomplete alveolar differentiation and insufficient pulmonary surfactant synthesis ( 1 – 3 ). Abnormal trajectories of pulmonary function development serve as the core contributing factors. Tidal breathing pulmonary function testing has emerged as the preferred approach for neonatal pulmonary function assessment…

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