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Observational Study
. 2016 Mar;137(3):e20150463.
doi: 10.1542/peds.2015-0463. Epub 2016 Feb 25.

Preterm Versus Term Children: Analysis of Sedation/Anesthesia Adverse Events and Longitudinal Risk

Jeana E Havidich  1 , Michael Beach  2 , Stephen F Dierdorf  3 , Tracy Onega  2 , Gautham Suresh  2 , Joseph P Cravero  4
Affiliations
Observational Study

Preterm Versus Term Children: Analysis of Sedation/Anesthesia Adverse Events and Longitudinal Risk

Jeana E Havidich et al. Pediatrics. 2016 Mar.

Abstract

Background and objectives: Preterm and former preterm children frequently require sedation/anesthesia for diagnostic and therapeutic procedures. Our objective was to determine the age at which children who are born <37 weeks gestational age are no longer at increased risk for sedation/anesthesia adverse events. Our secondary objective was to describe the nature and incidence of adverse events.

Methods: This is a prospective observational study of children receiving sedation/anesthesia for diagnostic and/or therapeutic procedures outside of the operating room by the Pediatric Sedation Research Consortium. A total of 57,227 patients 0 to 22 years of age were eligible for this study. All adverse events and descriptive terms were predefined. Logistic regression and locally weighted scatterplot regression were used for analysis.

Results: Preterm and former preterm children had higher adverse event rates (14.7% vs 8.5%) compared with children born at term. Our analysis revealed a biphasic pattern for the development of adverse sedation/anesthesia events. Airway and respiratory adverse events were most commonly reported. MRI scans were the most commonly performed procedures in both categories of patients.

Conclusions: Patients born preterm are nearly twice as likely to develop sedation/anesthesia adverse events, and this risk continues up to 23 years of age. We recommend obtaining birth history during the formulation of an anesthetic/sedation plan, with heightened awareness that preterm and former preterm children may be at increased risk. Further prospective studies focusing on the etiology and prevention of adverse events in former preterm patients are warranted.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

Figures

FIGURE 1. Percentage of patients in term and preterm categories that developed sedation/anesthesia adverse events by age group. Children in the preterm category experienced a higher frequency of adverse events.
FIGURE 1
Percentage of patients in term and preterm categories that developed sedation/anesthesia adverse events by age group. Children in the preterm category experienced a higher frequency of adverse events.
FIGURE 2. Locally weighted scatter plot regression of sedation/anesthesia adverse events comparing preterm and term patient categories. Preterm children <1 year of age were at higher risk for developing sedation/anesthesia adverse events. Patients in the preterm category were at higher risk regardless of age at the time of the procedure.
FIGURE 2
Locally weighted scatter plot regression of sedation/anesthesia adverse events comparing preterm and term patient categories. Preterm children <1 year of age were at higher risk for developing sedation/anesthesia adverse events. Patients in the preterm category were at higher risk regardless of age at the time of the procedure.
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Comment in

References

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