Minnesota Neonatal Physicians, Minneapolis, MN, USA.
Children's Minnesota Research Institute, Minneapolis, MN, USA.
J Perinatol. 2019 Oct;39(10):1411-1416. doi: 10.1038/s41372-019-0433-7. Epub 2019 Jul 18.
To evaluate the prevalence of sleep-disordered breathing (SDB) in infants with myelomeningocele (MMC) and the effect of fetal repair on SDB.
We conducted a retrospective cohort study of infants with MMC admitted to a pediatric hospital (2007-2017). Pneumocardiogram (PCG) results, a measure of SDB, were compared between infants who underwent fetal MMC (fMMC) versus postnatal MMC repair.
Of 118 eligible infants, 17 (14%) underwent fetal repair. Of these, 106 (90%) had PCG studies; abnormal PCG results were common but not different between fMMC (n = 12, 92%) and postnatal repair groups (n = 72, 77%, p = 0.22). Among infants with abnormal results, central apnea events >10 s (median 16 vs. 3 events, p = 0.02) and percentage of time spent in periodic breathing (median 15% vs. 7%, p = 0.01) were greater in the fMMC group.
SDB was common among all MMC infants regardless of repair timing, indicating a need for standard screening recommendations.
评估脊髓脊膜膨出（MMC）婴儿睡眠呼吸障碍（SDB）的患病率以及胎儿修复对 SDB 的影响。
我们对一家儿童医院（2007-2017 年）收治的 MMC 婴儿进行了回顾性队列研究。对接受胎儿 MMC（fMMC）与产后 MMC 修复的婴儿的肺心图（PCG）结果（SDB 的一种测量方法）进行了比较。
在 118 名符合条件的婴儿中，有 17 名（14%）接受了胎儿修复。其中，106 名（90%）进行了 PCG 研究；异常 PCG 结果很常见，但 fMMC 组（n=12，92%）与产后修复组（n=72，77%，p=0.22）之间并无差异。在异常结果的婴儿中，fMMC 组的中心性呼吸暂停事件>10 秒（中位数 16 次比 3 次，p=0.02）和周期性呼吸时间百分比（中位数 15%比 7%，p=0.01）更大。
无论修复时机如何，所有 MMC 婴儿的 SDB 都很常见，这表明需要有标准的筛查建议。
