Inflammatory Markers in Induced Sputum of School Children Born Before 32 Completed Weeks of Gestation

Objective To test whether chronic bronchial inflammation may be a contributing risk factor for persistent airflow limitation in children born before 32 weeks of gestation in later life. Study design Thirty-six of 160 children born before 32 completed weeks of gestation who were born between 1988 and 1992 were recruited at a median age of 11 years. Eighteen age-matched children born at term were controls; 47% of the premature infants and 61% of the term born children produced sputum of sufficient quality for interleukin (IL)-8, cell numbers, and differential counts. Results Compared with term born children, sputum from the premature group had a higher proportion of neutrophils (62% vs 3.8%; P P = .008). Forced expiratory flow 25%-75% and forced expiratory volume in 1 second/vital capacitywere significantly lower (73.4 % vs 116% predicted, P = .002 and 97% vs 101%, P = .012, respectively). Lung function values and sputum indices did not correlate. IL-8/protein and neutrophil percentages correlated significantly with decreasing gestational age (Spearman rank coefficient=−0.58, P = .020 and −.70, P =.03 respectively). Conclusion A significant proportion of school children born very preterm demonstrate persistent peripheral airway obstruction that is accompanied by neutrophilic lower airway inflammation.