Ignacio E Tapia1, Justine Shults2, Lex W Doyle3, Gillian M Nixon4, Christopher M Cielo1, Joel Traylor1, Carole L Marcus1. 1. Sleep Center, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA. 2. Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania. 3. Department of Obstetrics and Gynaecology, Royal Women's Hospital, Melbourne, Australia. 4. Melbourne Children's Sleep Centre, Monash Children's, Monash University, Melbourne, Australia.
Abstract
STUDY OBJECTIVES: The obstructive sleep apnea syndrome (OSAS) is more prevalent in ex-preterm children compared to the general pediatric population. However, it is unknown whether OSAS in ex-preterm children is associated with specific perinatal risk factors. This multicenter cohort study aimed to determine perinatal factors associated with OSAS at school age. METHODS: 197 ex-preterm (500-1,250 g) children aged 5-12 y who participated as neonates in a double-blind, randomized clinical trial of caffeine versus placebo (Caffeinefor Apnea of Prematurity) underwent comprehensive ambulatory polysomnography. A negative binomial regression model was used to identify perinatal risk factors associated with OSAS. RESULTS:19 children had OSAS (9.6%). Chorioamnionitis and multiple gestation were positively associated with OSAS with P values of 0.014 and 0.03, respectively. Maternal white race (P = 0.047) and maternal age (P = 0.002) were negatively associated with OSAS. Other risk factors, such as birth weight, Apgar score at 5 min, antenatal corticosteroids, delivery route, and sex were not significant. CONCLUSIONS:OSAS is very frequent, and is associated with chorioamnionitis and multiple gestation in ex-preterm children. Those born to older white mothers appear to be protected. We speculate that the former may be due to systemic inflammation and the latter to a higher socio-economic status. COMMENTARY: A commentary on this article appears in this issue on page 721.
RCT Entities:
STUDY OBJECTIVES: The obstructive sleep apnea syndrome (OSAS) is more prevalent in ex-preterm children compared to the general pediatric population. However, it is unknown whether OSAS in ex-preterm children is associated with specific perinatal risk factors. This multicenter cohort study aimed to determine perinatal factors associated with OSAS at school age. METHODS: 197 ex-preterm (500-1,250 g) children aged 5-12 y who participated as neonates in a double-blind, randomized clinical trial of caffeine versus placebo (Caffeine for Apnea of Prematurity) underwent comprehensive ambulatory polysomnography. A negative binomial regression model was used to identify perinatal risk factors associated with OSAS. RESULTS: 19 children had OSAS (9.6%). Chorioamnionitis and multiple gestation were positively associated with OSAS with P values of 0.014 and 0.03, respectively. Maternal white race (P = 0.047) and maternal age (P = 0.002) were negatively associated with OSAS. Other risk factors, such as birth weight, Apgar score at 5 min, antenatal corticosteroids, delivery route, and sex were not significant. CONCLUSIONS: OSAS is very frequent, and is associated with chorioamnionitis and multiple gestation in ex-preterm children. Those born to older white mothers appear to be protected. We speculate that the former may be due to systemic inflammation and the latter to a higher socio-economic status. COMMENTARY: A commentary on this article appears in this issue on page 721.
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