Management of prematurity-associated lung disease from infancy through to adulthood.

Preterm birth has lifelong pulmonary consequences, with many individuals developing prematurity-associated lung disease (PLD). This third paper in the prematurity-associated lung disease Series summarises current evidence for treatment and monitoring of PLD and its phenotypes. Preventive strategies, including maternal and infant vaccination to reduce early life viral exposures, are emerging as key interventions. Pharmacological approaches, such as inhaled corticosteroids, alone or combined with long-acting bronchodilators, show potential benefits in childhood, although there is currently little evidence on phenotype-specific responses. Management should also address extrapulmonary traits, including central airway abnormalities, cardiovascular sequelae, gastro-oesophageal reflux, impaired growth, neurodevelopmental disabilities, reduced physical exercise capacity, and environmental exposures. We discuss monitoring tools for early identification and longitudinal assessment of PLD, evaluation of treatment response, and recommendations for structured follow-up from infancy into adulthood, suitable for both general and specialist respiratory clinicians. Finally, opportunities for repurposing existing drugs and developing new therapies for PLD in children and adults are highlighted.