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  • Clinical Research Article
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Association between neonatal sepsis and lung function in school-age children born preterm

Pediatric Research (2026) Cite this article

Abstract

Background

Premature birth is associated with long-term respiratory sequelae, and impaired lung function is common in this population. Although bronchopulmonary dysplasia (BPD) is a known risk factor, the long-term impact of neonatal sepsis remains unclear. This study investigated the association between neonatal sepsis and lung function in school-aged children born preterm.

Methods

In this retrospective cohort study, clinical information including neonatal sepsis history was obtained from medical records. Standardized spirometry was performed. Multiple linear regression with sequential adjustments was used to evaluate the association between neonatal sepsis and lung function.

Results

A total of 125 preterm-born children completed lung function testing. Those with a history of neonatal sepsis exhibited lower VC, FEV₁, FVC, and MMEF compared with children without sepsis. In regression analyses, neonatal sepsis remained significantly associated with reduced MMEF after full adjustment for potential confounders. Associations with other spirometric parameters were no longer significant once BPD was included in the models.

Conclusion

Neonatal sepsis was independently associated with diminished small airway function in school-aged children born preterm, highlighting the importance for infection prevention and long-term respiratory follow-up in this vulnerable population.

Impact

  • Children born preterm with neonatal sepsis are an understudied population whose long-term lung outcomes remain unclear.

  • This study separates the influence of neonatal sepsis from BPD-related pathways in affecting long-term lung function.

  • We identify neonatal sepsis as a contributor to small airway impairment independent of BPD.

  • The findings highlight the importance of targeted respiratory follow-up for preterm children with a history of neonatal sepsis.

  • Emphasizing infection prevention strategies in early life may help protect long-term respiratory health in this vulnerable population.

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Fig. 1: Flow diagram of participant identification, invitation, response, and enrollment in the school-age follow-up study.
The alternative text for this image may have been generated using AI.
Fig. 2: Box plots of lung function parameters comparing preterm children with and without neonatal sepsis.
The alternative text for this image may have been generated using AI.
Fig. 3: Box plots of lung function parameters comparing preterm children with varying severity of BPD after adjustment for gestational age, sex, and antenatal corticosteroid use.
The alternative text for this image may have been generated using AI.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request for non-commercial research purposes. All shared data will be de-identified to protect participant confidentiality.

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Acknowledgements

The authors thank the clinical and nursing staff of the Children’s Medical Center at Taichung Veterans General Hospital for their assistance with data collection and patient follow-up.

Funding

This study was supported by the Taichung Veterans General Hospital Research Fund (grant number TCVGH-1116502B).

Author information

Authors and Affiliations

  1. Children’s Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan

    Ching-Chu Chen, Yi-Hsuan Lin, Yi-Feng Lee, Hui-Chi Chang, Lin-Shien Fu, Teh-Ming Wang, Ming-Chih Lin, Ya-Chi Hsu & Chung-Ting Hsu

  2. Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan

    Yi-Hsuan Lin, Lin-Shien Fu, Ming-Chih Lin & Chung-Ting Hsu

  3. Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Yi-Hsuan Lin

  4. Department of Biomedical Engineering & Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan

    Chung-Ting Hsu

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  1. Ching-Chu Chen
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Contributions

Conception and design of the study: Chung-Ting Hsu. Acquisition of data: Ching-Chu Chen, Yi-Feng Lee, Hui-Chi Chang, Lin-Shien Fu. Analysis and interpretation of data: Yi-Hsuan Lin, Teh-Ming Wang, Ming-Chih Lin, Ya-Chi Hsu. Drafting of the article: Ching-Chu Chen. Critical revision for important intellectual content: Yi-Hsuan Lin, Chung-Ting Hsu. Final approval of the version to be published: Chung-Ting Hsu.

Corresponding author

Correspondence to Chung-Ting Hsu.

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Competing interests

The authors declare no competing interests.

Consent statement

Written informed consent was obtained from all participating children and their parents in accordance with the requirements of the Institutional Review Board of Taichung Veterans General Hospital (IRB number: CF22177B).

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Chen, CC., Lin, YH., Lee, YF. et al. Association between neonatal sepsis and lung function in school-age children born preterm. Pediatr Res (2026). https://doi.org/10.1038/s41390-026-04931-7

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