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Chronic Obstructive Pulmonary Disease Following Bronchopulmonary Dysplasia

  • Alice HadchouelEmail author
  • Christophe Delacourt
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Part of the Respiratory Medicine book series (RM)

Abstract

Chronic obstructive pulmonary disease (COPD) in adults is characterized by a slowly progressive airflow limitation that is not fully reversible. The quality of fetal/neonatal lung development is critical to the level of pulmonary function in adults. Because premature birth is associated with a definitive obstructive airflow pattern in children and adults, it may represent a significant risk factor for the occurrence of COPD. The mechanisms contributing to this persistent obstruction, despite major advances in neonatal care, remain hypothetical. Impaired alveolarization may contribute to changes in respiratory mechanics, by reducing attachments between bronchioles and alveoli, resulting in an obstructive profile. It is also possible that molecular factors involved in branching morphogenesis have additional roles in later stages of development, thus contributing to disrupted airway growth. Finally, recent data suggest that accelerated cellular aging would also contribute to the long-term respiratory consequences of premature birth. In adolescents and young adults born prematurely and having a functional impairment, progressive decline to the diagnostic threshold of COPD would be even faster if and when active smoking is started. Active measures are warranted at an early stage to prevent/ameliorate the decline in lung function in COPD following the scenario of premature birth and BPD.

Keywords

Preterm Airway Alveolarization Lung function Smoking 
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© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Pediatric Pulmonology, Necker-Enfants Malades HospitalParisFrance
  2. 2.INSERMCréteilFrance
  3. 3.Paris-Descartes University, Sorbonne Paris CitéParisFrance

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