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VOLUME 35, ISSUE 11

SLEEP APNEA IN EARLY CHILDHOOD ASSOCIATED WITH PRETERM BIRTH
Sleep Apnea in Early Childhood Associated with Preterm Birth but Not Small for Gestational Age: A Population-Based Record Linkage Study

http://dx.doi.org/10.5665/sleep.2192

Camille H. Raynes-Greenow, PhD1,2; Ruth M. Hadfield, PhD2; Peter A. Cistulli, PhD3; Jenny Bowen, PhD4; Hugh Allen, MBBS5; Christine L. Roberts, DrPH2

1Sydney School of Public Health, University of Sydney, Australia; 2Clinical and Population Perinatal Health Research, Kolling Institute, University of Sydney, Australia; 3Department of Respiratory and Sleep Medicine, Royal North Shore Hospital and Discipline of Sleep Medicine, University of Sydney, NSW, Australia; 4Obstetrics, Gynaecology and Neonatology, Northern Clinical School, University of Sydney, NSW, Australia; 5Department of Paediatrics, Royal North Shore Hospital, NSW, Australia



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Study Objectives:

Investigate the relationship between gestational age and weight for gestational age and sleep apnea diagnosis in a cohort of children aged up to 6 years old.

Design:

A cohort study, using record linked population health data.

Setting:

New South Wales, Australia.

Participants:

398,961 children, born between 2000 and 2004, aged 2.5 to 6 years.

Measurements:

The primary outcome was sleep apnea diagnosis in childhood, first diagnosed between 1 and 6 years of age. Children with sleep apnea were identified from hospital records with the ICD-10 code G47.3: sleep apnea, central or obstructive.

Results:

A total of 4,145 (1.0%) children with a first diagnosis of sleep apnea were identified. Mean age at first diagnosis was 44.2 months (SD 13.9). Adenoidectomy, tonsillectomy, or both were common among the children diagnosed with sleep apnea (85.6%). Children born preterm compared to term were significantly more likely to be diagnosed with sleep apnea (< 32 weeks versus term hazard ratio 2.74 [95% CI: 2.16, 3.49]) this remained even after adjustment for known confounding variables. Children born small for gestational age were not at increased risk of sleep apnea compared to children born appropriate for gestational age, hazard ratio 0.95 (95% CI 0.86-1.06).

Conclusions:

This is the largest study investigating preterm birth and sleep apnea diagnosis and suggests that diagnosis of sleep disordered breathing is more prevalent in children born preterm, but not those who are small for gestational age.

Citation:

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(11):1475-1480.

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