Did your child arrive very early—before 32 weeks or weighing under 1.5 kg? Researchers from Frontiers in Pediatrics studied 93 children born extremely prematurely to understand how their lung development fared years later. By age 5, they discovered something important: these children's lungs don't always catch up to their peers.
The study used a simple breathing test called spirometry to measure how much air children's lungs could hold and how quickly they could breathe out. About 31% showed weaker lung function than expected, even though they were doing well otherwise.
Nearly one-third of very premature children still show weak lungs at preschool age
The concerning finding was that children with weaker lungs responded strongly to bronchodilators—medications that open airways. This suggests their airways are overreactive and tighten easily, similar to asthma. The lung weakness persisted years after birth, meaning it wasn't a temporary newborn problem.
Certain warning signs predict which premature children face higher lung risks
Not all very premature babies develop lasting lung problems. The study identified specific risk factors:
- Longer time on breathing machines: Children who needed mechanical ventilation (breathing support) for extended periods had worse lung function.
- Certain hospital steroids: Some premature infants received glucocorticoids to help lung development in hospital, but those who did were more likely to have ongoing issues.
- Family allergies or asthma: If allergies or asthma run in your family, your premature child faces higher risk.
- Frequent chest infections: Children who caught repeated colds, bronchitis, or respiratory infections showed poorer lung function.
Your child's prematurity history matters for doctors today
Many Singapore families may not connect their 5-year-old's frequent coughs or occasional need for asthma medication to their premature birth. In our tropical climate where respiratory infections are common, this link is easy to miss. However, knowing your child's prematurity baseline—especially how long they needed breathing support—helps doctors spot problems earlier if they develop.
- Keep detailed records of your child's hospital stay, particularly duration of breathing machine use and any steroid medications received.
- Tell your child's doctor about frequent coughs, colds lasting longer than usual, or shortness of breath during play—especially if you have family history of asthma or allergies.
- Ask your doctor whether a baseline lung function test makes sense for your child, particularly if they had multiple risk factors in the list above.