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. 2017 Nov 15;13(11):1311-1317.
doi: 10.5664/jcsm.6804.

Neurodevelopmental Outcomes at Two Years of Age for Premature Infants Diagnosed With Neonatal Obstructive Sleep Apnea

Anuja Bandyopadhyay  1 , Heidi Harmon  2 , James E Slaven  3 , Ameet S Daftary  1
Affiliations

Neurodevelopmental Outcomes at Two Years of Age for Premature Infants Diagnosed With Neonatal Obstructive Sleep Apnea

Anuja Bandyopadhyay et al. J Clin Sleep Med. .

Abstract

Study objectives: Neurocognitive deficits have been shown in school-aged children with sleep apnea. The effect of obstructive sleep apnea (OSA) on the neurodevelopmental outcome of preterm infants is unknown.

Methods: A retrospective chart review was performed for all preterm infants (< 37 weeks) who had neonatal polysomnography (PSG) and completed neurodevelopmental assessment with the Bayley Scales of Infant and Toddler Development, 3rd Edition, between 2006 to 2015 at Riley Hospital. Exclusion criteria included grade IV intraventricular hemorrhage, tracheostomy, cyanotic heart disease, severe retinopathy of prematurity, craniofacial anomalies, or central and mixed apnea on PSG. Sleep apnea was defined as an apnea-hypopnea index (AHI) > 1 event/h. Regression analyses were performed to find a relationship between PSG parameters and cognitive, language, and motor scores.

Results: Fifteen patients (males: n = 10) were eligible for the study. Median postmenstrual age at the time of the PSG was 41 weeks (37-46). Median AHI for the cohort was 17.4 events/h (2.2-41.3). Median cognitive, language, and motor scores were 90 (65-125), 89 (65-121), and 91 (61-112), respectively. Mean end-tidal CO2 (median 47 mm Hg [25-60]) negatively correlated with cognitive scores (P = .01) but did not significantly correlate with language or motor scores. AHI was not associated with cognitive, language, or motor scores.

Conclusions: The median score for cognitive, language, and motor scores for preterm infants with neonatal OSA were within one standard deviation of the published norm. Mean end-tidal CO2, independent of AHI, may serve as a biomarker for predicting poor cognitive outcome in preterm infants with neonatal OSA.

Commentary: A commentary on this article appears in this issue on page 1233.

Keywords: infant; newborn; obstructive sleep apnea; polysomnography.

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Figures

Figure 1
Figure 1. Relationship between cognitive composite score versus AHI and mean ETCO2.
AHI = apnea-hypopnea index, ETCO2 = end-tidal CO2.
See this image and copyright information in PMC

Comment in

  • Infants Sleep for Brain.
    Grigg-Damberger MM, Wolfe KM. Grigg-Damberger MM, et al. J Clin Sleep Med. 2017 Nov 15;13(11):1233-1234. doi: 10.5664/jcsm.6786. J Clin Sleep Med. 2017. PMID: 28992837 Free PMC article. No abstract available.

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