Long-term expiratory airflow of infants born moderate-late preterm: A systematic review and meta-analysis
Bibliographic record
Abstract
Background Moderate-late preterm (MLP; 32 to <37 weeks' gestation) birth is associated with reduced expiratory airflow during child, adolescent and adult years.However, some studies have reported only minimal airflow limitation and hence it is unclear if clinical assessment in later life is warranted.Our aim was to compare maximal expiratory airflow in children and adults born MLP with term-born controls, and with expected norms. MethodsWe systematically reviewed studies reporting z-scores for spirometric indices (forced expired volume in 1 second [FEV 1 ], forced vital capacity [FVC], FEV 1 /FVC ratio and forced expiratory flow at 25-75% of FVC [FEF 25-75% ]) from participants born MLP aged five years or older, with or without a term-born control group from 4 databases (MEDLINE, CINAHL, Embase, Emcare).Publications were searched for between the 22 nd of September 2021 to the 29 th of September 2021.A meta-analysis of eligible studies was conducted using a random effects model.The study protocol was published in PROSPERO (CRD #42021281518).Findings We screened 4970 articles and identified 18 relevant studies, 15 of which were eligible for meta-analysis (8 with term-born controls and 7 without).Compared with controls, MLP participants had lower z-scores (mean difference [95% confidence interval] I 2 ) for FEV 1 : -0.22 [-0.35, -0.09] 49.3%, FVC: -0.23 [-0.4,-0.06] 71.8%, FEV 1 /FVC: -0.11 [-0.20 to -0.03] 9.3% and FEF 25-75% : -0.27 [-0.41 to -0.12] 21.9%.Participants born MLP also had lower z-scores, on average, when compared with a z-score of 0 (mean [95% CI] I 2 ) for FEV 1 : -0.26 [-0.40 to -0.11] 85.2%, FVC: -0.18 [-0.34 to -0.02] 88.3%, FEV 1 /FVC: -0.24 [-0.43 to -0.05] 90.5% and FEF 25-75% : -0.33 [-0.54 to -0.20] 94.7%.Interpretation Those born MLP had worse expiratory airflows than those born at term, and compared with norms, although reductions were modest.Clinicians should be aware that children and adults born MLP may be at higher risk of obstructive lung disease compared with term-born peers.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.025 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.016 | 0.030 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".