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The effects of gestational age at birth on respiratory and vascular outcomes in childhood

Edwards, Martin 2016. The effects of gestational age at birth on respiratory and vascular outcomes in childhood. PhD Thesis, Cardiff University.
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This thesis is a combination of three interlinking projects exploring the association of gestational age at birth with abnormal vascular function measurements, increased respiratory symptoms and reduced exercise capacity in childhood. The main aim of my thesis was to identify any evidence of early disease processes (respiratory or vascular) in children born preterm. My first objective was to investigate the association between preterm birth and markers of vascular disease in childhood using data from Avon Longitudinal Study of Parents and Children (ALSPAC), and to review the literature reporting on arterial stiffness and/or endothelial dysfunction in preterm-born children. In my second project I conducted a systematic review of the literature with the objective to answer the question: Do survivors of preterm birth have reduced cardiorespiratory exercise capacity? My final project was to set up a cross-sectional study of children in Wales to test if lower gestational age at birth is associated with increased respiratory symptoms, admission rates to hospital and inhaler use for respiratory disease; independent of atopy. My first research project, using data from ALSPAC, noted an association between gestational age and SBP but not with measures of vascular function in childhood suggesting that alternative mechanisms may be responsible for increased SBP in preterm-born children. These results were supported by the findings of the seventeen articles identified by my systematic review. In my second project, a systematic review of the literature, I noted that despite marked deficits in lung spirometry, preterm-born children have only marginally decreased VO2max, which is unlikely to be of great clinical significance. Finally in my cross-sectional survey, I showed that increasing prematurity, and children who were born at early term, are associated with increased respiratory symptoms and utilization of healthcare services throughout childhood, which is independent of a family history of atopy or mode of delivery.

Item Type: Thesis (PhD)
Date Type: Completion
Status: Unpublished
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Date of First Compliant Deposit: 8 September 2016
Last Modified: 20 Dec 2021 12:11

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