Awareness Among Brazilian Medical Specialists of the Long-term Implications of Premature Birth on Lifelong Pulmonary Health: Results of the Brazilian Pre-tell Survey

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Abstract Introduction: Increasing evidence suggests that premature-born individuals have an increased risk of respiratory morbidity and mortality, airflow obstruction, asthma-like symptoms, and COPD. Whether early life events are considered by physicians providing life-long respiratory care to these individuals is unknown. The PRE-TELL (PRE matures T owards E ffective L ifelong L ung care) survey was designed to assess the level of awareness of the medical community regarding the long-term implications of premature birth on lung health. Methods: The PRE-TELL questionnaire consists of 21 items with categorical answers inquiring about the awareness of the medical community about the long-term respiratory risks of premature birth. The first wave of the PRE-TELL was run in Europe, Australia, and the US. Here, we present the results of the second wave of PRE-TELL from Brazilian medical specialists who participated in the online survey from April 2024 to July 2024. Results: A total of 5738 physicians reached, and 183 responses were collected (response rate: 3.19%): 82 were neonatologists, 26 pediatricians, 9 allergologists, and 66 adult pulmonologists. Most participants (>65%) have more than 10 years of experience, and most pediatricians, allergologists, and pulmonologists (>80%) practice in outpatient facilities. Respondents perceive low awareness about this topic among the Brazilian medical community. Notably, 89% of responding pulmonologists perceive “moderate” to “very low awareness” among their colleagues. Neonatologists and pediatricians (>95%) consider prematurity and bronchopulmonary dysplasia (BPD) risk factors for the development of future lung diseases. Notably, however, 48% of pulmonologists “strongly disagree” on considering prematurity and BPD risk factors of future lung disease, and 41% of them “strongly disagree” with preterm-born individuals requiring lifelong respiratory follow-up. The survey identified a relevant gap in the transmission of neonatal information. Neonatologists and pediatricians share and revise neonatal information using the discharge summary (>95%), whereas just 6% of pulmonologists use this information channel (Figure1). Pulmonologists consider fewer pieces of information and mostly receive it directly from patients or caregivers (74%). Twenty-one percent of pulmonologists do not review any neonatal information. Most respondents (80%) consider further education and empowering patients in their role to transmit relevant neonatal information as potential solutions to improve the lifelong respiratory care of preterm-born individuals. Conclusion: The survey results indicate the need to increase awareness among the Brazilian medical community about the long-term respiratory consequences of premature birth and improve communication between respiratory healthcare professionals across the developmental course. A better understanding of early-life events may improve the respiratory care of preterm-born individuals.

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