Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH 44106, USA.
Acta Paediatr. 2013 Jan;102(1):e39-43. doi: 10.1111/apa.12033. Epub 2012 Nov 1.
To describe the prevalence of paediatric sleep disordered breathing (SDB) symptoms in extremely low gestational age infants and identify neonatal risk factors, including early exposure to hypoxia and hyperoxia.
Patients <28 weeks gestation were monitored with high-resolution pulse oximetry. Hypoxia/hyperoxia variables were defined as percentage time of first 4 weeks of life that SaO(2) < 80% or SaO(2) > 98%, respectively. Parents completed part of the OSA-18 questionnaire for symptoms of SDB at 18-22 months. Logistic regression was used to test the association between risk factors and sleep symptoms.
Of 182 patients recruited, 138 (76%) completed the questionnaire. The mean gestation was 26 weeks, and mean birth weight 887 grams. Loud snoring (21%) and restless sleep (24%) were the most prevalent symptoms. Female sex was associated with an increased risk of loud snoring (OR, 2.7; CI, 1.13-6.5). Prolonged mechanical ventilation, necrotizing enterocolitis and prolonged caffeine use, however, were inversely correlated with loud snoring. Neither neonatal hypoxia nor hyperoxia were associated with sleep symptoms.
While the prevalence of sleep disordered breathing symptoms is similar to reported rates, we found a sex difference not previously reported. Interestingly, markers for severity of illness show a pattern of being protective against loud snoring.
描述极低胎龄儿（gestational age infants）中儿童睡眠呼吸障碍（SDB）症状的流行情况，并确定新生儿相关危险因素，包括早期缺氧和高氧暴露。
对胎龄<28 周的患儿进行高分辨率脉搏血氧饱和度监测。将低氧/高氧变量定义为 SaO2<80%的时间百分比和 SaO2>98%的时间百分比，分别为出生后前 4 周的时间百分比。患儿父母在 18-22 个月时使用 OSA-18 问卷完成部分 SDB 症状评估。采用逻辑回归检验危险因素与睡眠症状之间的关联。
共纳入 182 例患儿，其中 138 例（76%）完成了问卷调查。平均胎龄为 26 周，平均出生体重为 887 克。最常见的症状为打鼾（21%）和睡眠不安（24%）。女性与打鼾风险增加相关（OR，2.7；95%CI，1.13-6.5）。然而，延长机械通气、坏死性小肠结肠炎和延长咖啡因使用与打鼾减少相关。新生儿低氧和高氧均与睡眠症状无关。
虽然睡眠呼吸障碍症状的流行率与报道的比率相似，但我们发现了一个以前未报道的性别差异。有趣的是，疾病严重程度的标志物表现出对打鼾有保护作用的模式。
