Background: Preterm individuals show an altered breathing pattern in infancy, and lung function impairment tracking from child- to adulthood. However, little is known about the association of infant tidal breathing and later lung function.

Aim: Assess whether infant tidal breathing is associated with later lung function in preterm-born adolescents.

Methods: Preterm individuals born in 2000-2006 were prospectively followed-up from infancy to adolescence. We assessed the association of infant tidal breathing parameters (respiratory rate, tidal volume, minute ventilation, ratio of time to peak expiratory flow and expiratory time) with forced expiratory volume in 1 second (FEV₁), the ratio of residual volume and total lung capacity (RV/TLC), and lung clearance index (LCI) in adolescence by linear regression analyses, adjusting for sex, gestational age, birthweight, age and body height at study visit.

Results: We included 47 preterm individuals with a mean±SD gestational age of 29±3 weeks, 57% were male. Mean±SD age at study visit was 45±2 postconceptional weeks in infancy and 17±1 years at follow-up. We found that minute ventilation as the only infant tidal breathing parameter was significantly associated with RV/TLC z-score (?=0.005, 95% CI 0.001-0.008, P=0.013, R²=26%) and LCI (?=0.002, 95% CI 0.001-0.004, P=0.007, R²=13%) in adolescence, but not with FEV₁, also after adjustment for bronchopulmonary dysplasia.

Conclusion: In our preterm cohort, an increase in infant minute ventilation was associated with increased hyperinflation (RV/TLC) and ventilation inhomogeneity (LCI) in adolescence, suggesting that early changes in breathing pattern might indicate later changes, but not for airway obstruction.