Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2016 Apr 1;39(4):737-42.
doi: 10.5665/sleep.5618.

Perinatal Risk Factors Associated with the Obstructive Sleep Apnea Syndrome in School-Aged Children Born Preterm

Ignacio E Tapia  1 , Justine Shults  2 , Lex W Doyle  3 , Gillian M Nixon  4 , Christopher M Cielo  1 , Joel Traylor  1 , Carole L Marcus  1 ; Caffeine for Apnea of Prematurity – Sleep Study Group
Collaborators, Affiliations
Multicenter Study

Perinatal Risk Factors Associated with the Obstructive Sleep Apnea Syndrome in School-Aged Children Born Preterm

Ignacio E Tapia et al. Sleep. .

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 (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.

Keywords: OSAS; preterm; risk factors; school-aged.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Incidence rate ratio of maternal age at delivery associated with obstructive sleep apnea syndrome at school age. Second, third, and fourth maternal age quartiles are referenced to the first quartile. The closed circles represent the incidence rate ratio and the open circles the 5th and 95th confidence intervals. Values below 1 are protective. First age quartile: 20.8–27.6 y, second age quartile: 27.6–31.6 y, third age quartile: 31.7–34.9 y, fourth age quartile: 35–47 y. Children born to older mothers had a lower incidence rate ratio of obstructive sleep apnea syndrome at school age.
See this image and copyright information in PMC

Comment in

References

    1. Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc. 2008;5:242–52. - PMC - PubMed
    1. Rosen CL, Larkin EK, Kirchner HL, et al. Prevalence and risk factors for sleep-disordered breathing in 8- to 11-year-old children: association with race and prematurity. J Pediatr. 2003;142:383–9. - PubMed
    1. Paavonen EJ, Strang-Karlsson S, Raikkonen K, et al. Very low birth weight increases risk for sleep-disordered breathing in young adulthood: the Helsinki Study of Very Low Birth Weight Adults. Pediatrics. 2007;120:778–84. - PubMed
    1. Calhoun SL, Vgontzas AN, Mayes SD, et al. Prenatal and perinatal complications: is it the link between race and SES and childhood sleep disordered breathing? J Clin Sleep Med. 2010;6:264–9. - PMC - PubMed
    1. Raynes-Greenow CH, Hadfield RM, Cistulli PA, Bowen J, Allen H, Roberts CL. Sleep apnea in early childhood associated with preterm birth but not small for gestational age: a population-based record linkage study. Sleep. 2012;35:1475–80. - PMC - PubMed

Publication types

MeSH terms