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Looking beyond bronchopulmonary dysplasia: prematurity-associated lung disease and its phenotypes

Course, Christopher William, Bush, Andrew and Kotecha, Sailesh ORCID: https://orcid.org/0000-0003-3535-7627 2026. Looking beyond bronchopulmonary dysplasia: prematurity-associated lung disease and its phenotypes. The Lancet Respiratory Medicine 14 (1) , pp. 60-71. 10.1016/S2213-2600(25)00372-8

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Abstract

Preterm birth is increasingly recognised as a determinant of chronic respiratory disease across the life course. In this Series on prematurity-associated lung disease (PLD), we introduce the concept of PLD as a unifying framework for the diverse pulmonary consequences of preterm birth. Historically, most attention has focused on extremely preterm infants (<28 weeks of gestation) who develop bronchopulmonary dysplasia (BPD), yet not all infants with BPD have long-term morbidity. Conversely, those born very (28–31 weeks), moderate (32–33 weeks), or late (34–36 weeks) preterm also have increased risk for developing lung disease. Multiple factors beyond BPD—including gestational age and intrauterine growth restriction—contribute to PLD development. Recently described PLD phenotypes include prematurity-associated obstructive lung disease, prematurity-associated preserved ratio impaired spirometry, and prematurity-associated dysanapsis. Each phenotype reflects distinct early-life exposures and mechanisms, with differing implications for prognosis. Defining these phenotypes provides a foundation for personalised monitoring and targeted therapeutic strategies.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Schools > Medicine
Additional Information: RRS applied 02/12/2025 AB
Publisher: Elsevier
ISSN: 2213-2600
Funders: MRC
Projects: RHiNO
Date of First Compliant Deposit: 2 December 2025
Date of Acceptance: 23 October 2025
Last Modified: 13 Jan 2026 15:15
URI: https://orca.cardiff.ac.uk/id/eprint/182763

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