Birth weight, subsequent growth, and cholesterol metabolism in children 8-12 years old born preterm.

AIMS: To test the hypothesis that plasma lipids, lipoproteins, and markers of cholesterol biosynthesis (lathosterol) and absorption efficiency (campesterol) in children aged 8-12 years are related to birth size and subsequent growth. METHODS: A total of 412 girls and boys weighing less than 1850 g at birth were studied. Birth weight, gestation, and weight at 18 months were recorded and followed up at 8-12 years. Plasma total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B, triacylglycerol, lathosterol, and campesterol were measured. RESULTS: Birth weight for gestational age was positively related to plasma campesterol, and remained so after adjusting for current body size or fatness. Birth weight was negatively related to current plasma lathosterol but only after adjusting for current body size or fatness. For both lathosterol and campesterol the significant relation with birth size adjusted for current size indicates that the change in size between these points (postnatal upward centile crossing) was influential. These relations were absent for total cholesterol, lipoproteins, apolipoproteins, and triacylglycerol. CONCLUSION: Preterm children who were smaller for gestational age at birth had lower predicted cholesterol absorption efficiency 8-12 years later. Among children of the same current size, predicted endogenous cholesterol synthesis was higher and cholesterol absorption efficiency lower in those who showed the greatest increase in weight centile between birth and follow up. This finding was not confined to children with the smallest birth weights for gestational age. We suggest that both fetal and childhood growth relate to programming of cholesterol metabolism in children born preterm.     

Birth weight, subsequent growth, and cholesterol metabolism in children 8-12 years old born preterm

AIMS—To test the hypothesis that plasma lipids, lipoproteins, and markers of cholesterol biosynthesis (lathosterol) and absorption efficiency (campesterol) in children aged 8-12 years are related to birth size and subsequent growth.
METHODS—A total of 412 girls and boys weighing less than 1850 g at birth were studied. Birth weight, gestation, and weight at 18 months were recorded and followed up at 8-12 years. Plasma total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B, triacylglycerol, lathosterol, and campesterol were measured.
RESULTS—Birth weight for gestational age was positively related to plasma campesterol, and remained so after adjusting for current body size or fatness. Birth weight was negatively related to current plasma lathosterol but only after adjusting for current body size or fatness. For both lathosterol and campesterol the significant relation with birth size adjusted for current size indicates that the change in size between these points (postnatal upward centile crossing) was influential. These relations were absent for total cholesterol, lipoproteins, apolipoproteins, and triacylglycerol.
CONCLUSION—Preterm children who were smaller for gestational age at birth had lower predicted cholesterol absorption efficiency 8-12 years later. Among children of the same current size, predicted endogenous cholesterol synthesis was higher and cholesterol absorption efficiency lower in those who showed the greatest increase in weight centile between birth and follow up. This finding was not confined to children with the smallest birth weights for gestational age. We suggest that both fetal and childhood growth relate to programming of cholesterol metabolism in children born preterm.
     

Preterm birth and carotid diameter and stiffness in childhood

BACKGROUND AND AIM: Low birthweight, either as a result of poor foetal growth or preterm birth, is a risk factor for stroke in adult life. Carotid stiffening, an early marker of atheromatous disease, has been found in low-birthweight children born at term. We hypothesized that carotid artery growth and dynamic properties are permanently affected by preterm birth. METHODS: Carotid artery stiffness and dimensions in 56 school children, 39 born very preterm (mean gestational age [GA] 29 weeks) and 17 controls born at term, were studied by ultrasonic measurements of the pulsatile movements of the vessel wall. RESULTS: The carotid artery diameter was 6.4 mm both in children born preterm and at term (p=0.99). No difference in carotid stiffness was found. Within the preterm group, no differences could be seen between those born small for gestational age (SGA) or appropriate for gestational age (AGA). CONCLUSIONS: Carotid artery elasticity and structure are not altered after preterm birth. The mechanisms behind the increased stroke risk in adults born preterm remain unresolved.     

Plasma lipids, phospholipid fatty acids and indices of glycaemia in 10-year-old children born as small-for-gestational-age or preterm infants

Low birthweight has been epidemiologically associated with unfavourable plasma lipid profiles and enhanced risk of cardiovascular morbidity in adulthood. Plasma lipids, lipoprotein cholesterols, apolipoproteins, fatty acid composition of plasma phospholipids and basic indices of glycaemia were investigated in 10-y-old children born with similarly low birthweights as small-for-gestational-age (SGA; n = 16) or preterm infants (n = 16). Plasma total cholesterol (4.32 +/- 0.57 vs 4.60 +/- 0.52, mmol l(-1), mean +/- SD, SGA vs preterm subjects), low-density lipoprotein cholesterol (2.54 +/- 0.51 vs 2.65 +/- 0.51) and high-density lipoprotein cholesterol (1.61 +/- 0.25 vs 1.76 +/- 0.18) concentrations did not differ between the 2 groups. There was no difference in plasma triacylglycerol, apolipoprotein A-I and B, insulin and glucose concentrations or phospholipid fatty acid values. There was no correlation between indices of lipid and carbohydrate metabolism. In conclusion, plasma lipid profiles and basic indices of glycaemia are not different in 10-y-old children born with similarly low birthweights as SGA or preterm infants.     

Regional fat distribution in children born preterm evaluated at school age

Children born preterm may have aberrant adiposity. At school age, we evaluated body fat and fat distribution in 45 former preterm infants (birth weight < or = 1800 g and gestational age < 34 weeks) and 40 children born at term using dual-energy x-ray absorptiometry. Children born preterm exhibited lower total body fat mass and total body fat mass index compared with children born at term. Fat mass indexes in the limbs but not the trunk were lower in children born preterm than in children born at term. In conclusion, children born preterm, evaluated at school age, may be at risk for altered regional adiposity.     

Die neurologische und kognitive Entwicklung zu klein geborener Kinder

This article aims to provide an overview on the neurological and cognitive outcome of children who were “born too small”. We will discuss the neurodevelopmental prognosis of term born small for gestational age children, and for children born prematurely (appropriate and small for gestational age). The various underlying causes responsible for intrauterine growth retardation (IUGR) and significance for neurodevelopmental outcome will be discussed briefly. Neurodevelopmental outcome of term born children with IUGR due to intrauterine malnutrition and outcome of preterm born small for gestational age (SGA) as well as preterm born appropriate for gestational age (AGA) children will then be discussed in more detail. Children with IUGR represent a heterogeneous group regarding the underlying cause that is responsible for the growth retardation. Neurodevelopmental prognosis very much depends on the specific underlying cause. IUGR caused by intrauterine malnutrition is not necessarily associated with neurodevelopmental problems. However, results of several studies suggest that in term born children with IUGR mild neuromotor problems and lower full scale IQ is more frequent when compared with term born appropriate for gestational age children. Prematurely born children are at high risk for neurodevelopmental impairment. There is no difference in frequency of disabling impairments between AGA and SGA preterm children. However, in preterms with IUGR there seems to be a higher frequency of mild neuromotor problems and cognitive function seems to be poorer than in appropriate for gestational age preterms.     

Association between serum adipocytokine and cholesterol levels in cord blood

Background: Serum leptin and adiponectin levels are strongly associated with lipid metabolism in adults. These adipocytokines play a role in intrauterine and postnatal growth but the association between cord blood levels of these adipocytokines and cholesterol at birth remains unclear. Methods: The study involved 52 appropriate‐for‐gestational‐age (AGA) infants (25 male, 27 female, 37–41 weeks of gestational age) born at Keiai Hospital without any maternal complications. Cord blood concentrations of leptin, total adiponectin, total cholesterol (TC), low‐density lipoprotein cholesterol (LDL‐C), other neonatal characteristics, and maternal factors were assessed to investigate the association between cord blood leptin or adiponectin levels and cholesterol levels. Results: Cord blood leptin levels were significantly higher in girls. Simple regression analysis indicated that cord blood leptin levels were significantly associated with birthweight, gestational age, birthweight SD score, body mass index (BMI), ponderal index, LDL‐C, and TC; but total adiponectin levels were not significantly associated with any neonatal characteristics or maternal factors. A multiple regression analysis indicated that cord leptin levels were significantly associated with BMI (β= 0.407, P= 0.001), LDL‐C (β=?0.345, P= 0.004), and infant's gender (β=?0.332, P= 0.006); adiponectin levels were significantly associated with only gestational age (β= 0.279, P= 0.047). Conclusion: Cord leptin level is significantly associated with cord cholesterol level at birth, anthropometry, and infant gender. The present study suggests that cord blood leptin may be a key hormone for controlling fetal lipid metabolism.     

Lung function in children born after foetal growth restriction and very preterm birth

Aims: To assess lung function at early school age in children delivered at very early gestation owing to intrauterine growth restriction and abnormal foetal blood flow (IUGR). Methods: Spirometry was performed at median age 8.4 (range 6.5–10.7) years in 31 children born preterm with IUGR (PT‐IUGR) with a median (range) birth weight (BW) of 650 (395–976) g and median (range) gestational age 27 (24–29) weeks. Control groups were matched for gender and age and had BW appropriate for gestational age (AGA); 31 children born preterm (PT‐AGA) with BW of 1010 (660–1790) g matched for gestational age at birth, and 31 children born at term (T‐AGA) with BW of 3530 (3000–4390) g. Results: The PT‐IUGR group had lower mean (SD) values of z‐scores for FEV₁, FEV₁/FVC and forced mid‐expiratory flow rate (FEF_25–75%) compared to the T‐AGA group, p = 0.003, p = 0.032 and p < 0.001, respectively, but did not differ from the PT‐AGA group. PT‐IUGR children delivered at ≥26 gestational weeks (GW) had lower FEF_25–75% than PT‐AGA children of corresponding GA, p = 0.014. Conclusion: Lung function was reduced in the PT‐IUGR group at early school age compared to controls born at term. The influence of IUGR on later lung function was only apparent in children born preterm after 26 GW.     

Anti-oxidant enzymes and related elements in term and preterm newborns

Background:  Although oxidative stress-related diseases mostly affect neonates with extremely low birthweight, healthy preterm newborns might also be at risk of oxidative damages. The aim of the present study was to verify this possibility.
Methods:  Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), erythrocyte glutathione peroxidase (GSHPx) and superoxide dismutase (SOD), plasma and erythrocyte concentrations of selenium, zinc and copper were measured until 100 days of life in 30 preterm infants with mean ± SD birthweight and gestational age of 1605 ± 122 g and 34.5 ± 0.5 weeks. The control group included 30 term infants with birthweight 3123 158 g and gestational age 39.6 0.7 weeks.
Results:  Throughout the study period urinary 8-OHdG, taken as a marker of oxidative stress, was significantly higher in the preterm than in the term group. Up until 20 days of life, GSHPx activity was significantly lower in the preterm than in the term infants but this was not associated with any apparent selenium deficiency. Conversely, up until 100 days, preterm infants had significantly reduced SOD levels that appeared to reflect a shortage of the elements needed for this enzyme's activity, notably copper, the plasma concentrations of which were constantly and significantly below the control values.
Conclusion:  The nutritional status of the elements related to the anti-oxidant enzymes, especially zinc and copper, should be carefully assessed in preterm infants, even if their birthweight is not extremely low.     

中国三城市25 254例不同出生胎龄儿童神经行为发育水平研究

目的 探讨出生胎龄对学龄前儿童神经行为发育水平的影响。方法 来自安徽马鞍山市、浙江台州市、江苏扬州市的25 254例学龄前儿童纳入研究。根据所纳入儿童的出生胎龄,分为早产儿组（2 760例,胎龄28~36⁺⁶周）、早期儿组（6 005例,胎龄37~38⁺⁶周）、完全足月儿组（16 489例,胎龄≥39周）。采用年龄与发育进程问卷对儿童进行神经行为发育水平的评估。结果 早产儿组的沟通、粗大运动、精细运动、解决问题和个人-社会等5个能区的神经行为得分较完全足月儿组低（均P < 0.05）;早产儿组沟通、粗大运动、精细运动、解决问题4个能区神经行为得分较早期儿组低（均P < 0.05）;早期儿组各能区的平均分值与完全足月儿组相比,差异无统计学意义（均P > 0.05）。多元线性回归分析显示,校正了性别、年龄、体重指数、父母亲教育程度等混杂因素后,胎龄与5个发育能区（沟通、粗大运动、精细运动、解决问题和个人-社会）的得分呈显著正相关（P < 0.01）。结论 出生为早产儿的儿童神经行为发育水平较出生为完全足月儿和早期儿的儿童低,而出生为早期儿的儿童神经行为发育水平与出生为完全足月儿的儿童无明显差异。胎龄是神经行为发育水平的独立影响因素。     

Differences in insulin resistance markers between children born small for gestational age or born preterm appropriate for gestational age

Aim: To evaluate the impact of prenatal or postnatal compromised environment on glucose homoeostasis in children born preterm and appropriate for gestational age or small for gestational age (SGA) at term. Method: Seventy-seven children (median 9.9 years, range 8.5–10) born at Karolinska Hospital were allocated to three groups: 21 subjects born before 30 weeks of gestational age (preterm), 26 SGA at term and 30 at term with appropriate birth weight (control). Anthropometric measurements were taken, and fasting blood samples for haemoglobin A1c, glucose, insulin, IGFBP-1, IGF-1 and lipid profile were taken. Glucose, insulin and IGFBP-1 samples were taken at 0, 30 and 120 min during an oral glucose tolerance test (OGTT). Results: Subjects born preterm or SGA were shorter and thinner compared with Controls. After adjustment for body mass index (BMI), the SGA group had higher basal insulin levels (p = 0.029), higher homoeostasis model assessment—insulin resistance (p = 0.012) and lower whole-body insulin sensitivity index (p = 0.007) than Controls. IGFBP-1 decrease during OGTT was attenuated in the Preterm group compared with the Control (p = 0.045) and SGA groups (p = 0.007). Conclusion: The higher fasting insulin level in the SGA children, adjusted for BMI, could indicate peripheral insulin resistance. Preterm born children had reduced suppression of IGFBP-1 during OGTT, suggesting hepatic insulin resistance.     

SERUM LIPIDS IN MATERNAL/CORD BLOOD PAIRS FROM NORMAL AND LOW BIRTHWEIGHT INFANTS IN DAR ES SALAAM, TANZANIA

Abstract. Boersma, E. R. (Department of Child Health, Muhimbili Medical Centre, incorporating the Faculty of Medicine, University of Dar es Salaam, Tanzania). Serum lipids in maternal/cord blood pairs from normal and low birthweight infants in Dar es Salaam, Tanzania. Acta Paediatr Scand, 69:747, 1980.—Serum total cholesterol and triglyceride were determined in the cord blood of 54 term appropriate for gestational age, 14 preterm appropriate for gestational age and 17 small-for-dates infants and their mothers immediately after delivery in Dar es Salaam, Tanzania. The mean serum level of total cholesterol in cord blood of term appropriate for gestational age infants was 1.9 mmol/l, whereas that from their mothers 6.3 mmol/l. Cord serum triglyceride values in term appropriate for gestational age infants were 0.29 mmol/l and from their mothers 1.91 mmol/l. Results of these maternal cord serum lipids in the normal and low birthweight groups are similar to those of Western countries.     

Variation in size at birth in infants born small for gestational age in Lithuania

The aim of this study was to describe the heterogeneity in body proportions of infants born small for gestational age (SGA), defined by birthweight, and to study the relationship of placental size with neonatal anthropometric measurements. Anthropometry was evaluated in 107 symmetrically and asymmetrically growth-retarded infants born SGA (birthweight <-2 SD) and compared with 181 appropriate-for-gestational age infants (AGA; birthweight and length +/- 2 SD). Study children were born at Kaunas University Hospital during the period from 1 January 1998 to 25 August 2000. Two-thirds of SGA children were light (SGA(W)) and one-third was both light and short (SGA(WL)) for gestational age. Infants in both SGA groups were significantly leaner than AGA children. SGA(WL) infants had significantly larger heads in relation to their length compared with SGA(W) and even AGA children, probably indicating a brain-sparing effect. SGA(WL) children had the lowest mean placental weight, but the highest placental weight to birthweight (PW/BW) ratio. The PW/BW ratio was inversely correlated with most infant measurements; the strongest negative relationship was observed with birthlength and lower leg length. CONCLUSION: There is heterogeneity in children born SGA, defined by birthweight. It is suggested that the two SGA groups represent the continuum of intrauterine growth retardation, with an initial reduction in trophic growth and a subsequent retardation of linear growth. The PW/BW ratio is a strong indicator for impaired prenatal linear growth.     

Elevation of plasma lathosterol, as an indicator of increased cholesterol synthesis, in preterm (23-32 weeks gestation) infants given Intralipid.

Hypercholesterolemia is common in preterm infants administered 10% Intralipid perhaps because of excess phospholipid in plasma causing efflux of cholesterol from tissues. The purpose of this study was to determine if cholesterol synthesis (as measured by plasma lathosterol) is increased in preterm infants (23-32 wk gestation) during infusion of up to 4 g 10% Intralipid/kg body wt/d. Two groups of infants were studied. Intralipid intake was compared to: 1) plasma cholesterol in blood sampled over the first 100 d of life (preliminary study, n = 22) and 2) plasma cholesterol, lathosterol, and apo AI and B in blood taken at birth (cord), d 3-4 of life, and at least three additional times over the next 25 d (lathosterol study, n = 22). Lathosterol was quantitated by gas liquid chromatography and apo AI and B by immunoprecipitation. In the preliminary study, plasma cholesterol levels rose (to 4.06-10.70 mM) with Intralipid administration. Infants who received less than 2 g Intralipid/kg body wt/d were not hypercholesterolemic. In the lathosterol study, plasma cholesterol increased (1.86-2.24 mM, p = 0.06) and apo AI and B did not change, but lathosterol and the cholesterol:lathosterol ratio decreased (5.24-2.88 microM, p = 0.01, and 284-124 10(2) x mmol lathosterol:mol cholesterol, p = 0.007, respectively) from birth to d 3-4 (n = 11 paired samples). Infants followed longitudinally had increased cholesterol and lathosterol (4- to 7-fold) with increasing Intralipid administration, which decreased after discontinuation of infusion. Apo AI and B decreased upon Intralipid infusion.(ABSTRACT TRUNCATED AT 250 WORDS)     

Large variability in performance IQ associated with postnatal morbidity,and reduced verbal IQ among school-aged children born preterm

Aim: To assess cognitive ability in a population-based group of prematurely born school-aged children and to relate these findings to postnatal morbidity. Method: The study group consisted of a cohort of 51 children born preterm, 43 (26 boys, 17 girls) of whom were available for psychological evaluation At evaluation, their median age was 10 y (range 8-11 y). They were all born between 1988 and 1991, with gestational age less than 29 wk (median 27, range 24-28). Their median birthweight was 1060 g (range 450-1450). The Wechsler Intelligence Scale for Children (WISC-III) was used, and the test results were compared with those of a standardized, age-matched, normative group of children. Results: Thirteen children (30%) performed below average [intelligence quotient (IQ) 380] for Full Scale IQ (FSIQ). Thirty-six children had a Verbal IQ (VIQ) below the mean value of 100 [84%, 95% confidence interval 73-95%], p 3 0.0001. The Performance IQ (PIQ) was within the expected range of a normal population, although a large variability was observed. Discrepancies between VIQ and PIQ of more than 15 IQ units were found in 42% of the children. High postnatal morbidity (days with assisted ventilation, number of blood transfusions) and low birthweight standard deviation scores (SDS) were associated with lower PIQ than VIQ, while low postnatal morbidity and high birthweight were associated with higher PIQ than VIQ. Conclusion: This cohort of preterm children had reduced overall verbal capacity independent of morbidity, and a large variability in performance capacity that was associated with postnatal morbidity. The findings suggest that there are different mechanisms influencing the outcome of verbal and performance capacity in preterm children.     

Treatment of extremely preterm infants: parents' attitudes

AIM: To conduct a survey of the attitude towards treatment of extremely preterm infants by comparing the attitude towards life-saving treatment between a group of parents of extremely preterm children and parents in the general population. The importance the two groups of respondents assigned to parental preferences was also investigated. METHODS: A Danish national cohort of children born from 1994 to 1995 with a birthweight below 1000 g or a gestational age below 28 wk were assessed in a 5-y follow-up study including a reference group of children born at term. The parents of the children were given a sequence of case vignettes presenting different clinical situations, which formed part of a questionnaire. RESULTS: More than 80% of 222 possible index respondents and 76 possible reference respondents fulfilled the vignettes. Both groups of respondents were positive towards life-saving treatment of extremely preterm infants. The recommendations given by both groups were significantly influenced by the hypothetical child's risk of having a serious handicap and the parents' preferences. The results suggest that parents of extremely preterm children do not have a more conservative attitude towards life-saving treatment of extremely preterm infants than parents in the general population, and also support the view that parents' preferences should influence treatment decisions; although many believe that these should not be decisive. CONCLUSION: Compared to the general population, parents of children born extremely preterm did not express a more conservative attitude towards life-saving treatment of extremely preterm infants.     

Gestational age, birth weight, and the risk of hyperkinetic disorder.

AIMS: To study the association between gestational age and birth weight and the risk of clinically verified hyperkinetic disorder. METHODS: Nested case-control study of 834 cases and 20 100 controls with incidence density sampling. RESULTS: Compared with children born at term, children born with gestational ages of 34-36 completed weeks had a 70% increased risk of hyperkinetic disorder (rate ratio (RR) 1.7, 95% confidence interval (CI) 1.2 to 2.5). Children with gestational ages below 34 completed weeks had an almost threefold increased risk (RR 2.7, 95% CI 1.8 to 4.1). Children born at term with birth weights of 1500-2499 g had a 90% increased risk of hyperkinetic disorder (RR 1.9, 95% CI 1.2 to 2.9), and children with birth weights of 2500-2999 g had a 50% increased risk (RR 1.5, 95% CI 1.2 to 1.8) compared with children born at term with birth weights above 2999 g. The results were adjusted for socioeconomic status of the parents, family history of psychiatric disorders, conduct disorders, comorbidity, and maternal smoking during pregnancy. Results related to birth weight were unchanged after adjusting for differences in gestational age. CONCLUSIONS: Children born preterm, also close to term, and children born at term with low birth weights (1500-2499 g) have an increased risk of clinically verified hyperkinetic disorder. These findings have important public health perspectives because the majority of preterm babies are born close to term.     

Cognitive development and attention performances at school age of "normal" prematurely born children]

OBJECTIVE: A preterm birth can exert an influence on cognitive development. The aim of this study was to determine whether preterm birth may impact on attention executive processes, at school age, in children without neurological sequelae. DESIGN AND METHODS: Prematurely born children admitted in the level III NICU of the Maternité régionale of Nancy between 1992 and 1994, underwent at 8 to 10 years 8 subtests of the mental processing scales of the K-ABC, which assess process categories involved in learning. The children were also submitted to 3 tests that evaluate attention mechanisms efficiency (category fluency task, backward digits span, Tower of London). The controls were children born at term recruted in schools of the same area. RESULTS: The 124 children were born with birth weight appropriate for gestational age, and were in the school grades expected for their ages, in 3rd, 4rth, and 5fth grades. Fifty-three children were born at term, 29 were prematurely born (33-36 w), and 42 were very prematurely born (28-32 w). Birth term was significantly correlated (P < 0.001) with scores at sequential processing scale, at simultaneous processing scale and at the mental processing composite scale. At this scale, the children born at term obtained a median score of 112, the children prematurely born of 101, and the children very prematurely born of 98.5. For 40 third grade children (18 born at term, 10 prematurely born, and 12 very prematurely born), birth term was significantly correlated with performances at the 3 tests of attention. In all cases, preterm was inversely correlated with performances. CONCLUSION: The results are consistent with a lower efficiency in attention executive processes which may be related to the higher frequency of learning disabilities associated with prematurity.     

High density lipoprotein concentrations in newborn infants.

The lipoprotein pattern was analyzed by agarose gel electrophoresis in 19 new born infants of varying gestational age. The HDL concentration was determined by rocket immunoelectrophoresis in another 41 newborn infants. Infants with a gestational age of less than 33 weeks had very low HDL concentrations compared to preterm infants with a gestational age of less than or equal to 33 weeks and term ihfants. In the first 5-10 days after birth the HDL concentration increased markedly in preterm infants (gestational age less than 37 weeks) whereas it remained unchanged in term infants.     

Hyperinflation in premature infants at preschool age

Functional residual capacity was measured by helium gas dilution in 12 children born very preterm (gestational age 25-29 weeks). The children were studied at between 4.0 and 4.6 years of age. Their results were compared to those of 12 control children who were born at term without neonatal problems. The controls were matched to the children born preterm for age, race and gender. The children born preterm had significantly increased functional residual capacity values when compared to the control subjects (p less than 0.01). Eight children born preterm were hyperinflated (functional residual capacity greater than 120% of that predicted for height) compared to only one control subject (p less than 0.01). Five children born preterm and one control had a positive response to bronchodilator administration. These results suggest infants born very preterm may suffer from chronic hyperinflation.