Department of Respiratory and Sleep Medicine, Perth Children's Hospital, Nedlands, WA, Australia; Division of Pediatrics, Medical School, The University of Western Australia, Crawley, WA, Australia; Perioperative Medicine Team, Telethon Kids Institute, Nedlands, WA, Australia.
Centre for Sleep Science, School of Human Sciences, The University of Western Australia, Crawley, WA, Australia; West Australian Sleep Disorders Research Institute, Department of Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
Sleep Med. 2023 Oct;110:76-81. doi: 10.1016/j.sleep.2023.07.032. Epub 2023 Jul 29.
Early-life obstructive sleep apnoea (OSA) predictors are unavailable for young adults. This study identifies early-life factors predisposing young adults to OSA.
This retrospective study included 923 young adults and their mothers from the Western Australian Pregnancy Raine Study Cohort. OSA at 22 years was determined from in-laboratory polysomnography. Logistic regression was used to identify maternal and neonatal factors associated with OSA in young adulthood.
OSA was observed in 20.8% (192) participants. Maternal predictors of OSA included gestational diabetes mellitus (odds ratio (OR) 9.54, 95% confidence interval (CI) 1.7, 58.5, P = 0.011), preterm delivery (OR 3.18, 95%CI 1.1,10.5, P = 0.043), preeclampsia (OR 2.95, 95%CI 1.1,8.0, P = 0.034), premature rupture of membranes (OR 2.46, 95%CI 1.2, 5.2, P = 0.015), age ≥35 years (OR 2.28, 95%CI 1.2,4.4, P = 0.011), overweight and obesity (pregnancy BMI≥25 kg/m) (OR 2.00, 95%CI 1.2,3.2, P = 0.004), pregnancy-induced hypertension (OR 1.89, 95%CI 1.1,3.2, P = 0.019), and Chinese ethnicity (OR 2.36,95%CI 1.01,5.5, P = 0.047). Neonatal predictors included male child (OR 2.10, 95%CI 1.5,3.0, P < 0.0001), presence of meconium-stained liquor during delivery (OR 1.60, 95%CI 1.0,2.5, P = 0.044) and admission to special care nursery (OR 1.51 95%CI 1.0,2.2, P = 0.040). Higher birth lengths reduced OSA odds by 7% for each centimetre (OR 0.93, 95%CI 0.87, 0.99, P = 0.033).
A range of maternal and neonatal factors predict OSA in young adults, including those related to poor maternal metabolic health, high-risk pregnancy and stressful perinatal events. This information could assist in the early identification and management of at-risk individuals and indicates that better maternal health may reduce the likelihood of young adults developing OSA.
目前尚缺乏用于预测年轻成年人阻塞性睡眠呼吸暂停（OSA）的早期生活因素。本研究旨在确定导致年轻成年人发生 OSA 的早期生活因素。
本回顾性研究纳入了来自西澳大利亚妊娠 Raine 研究队列的 923 名年轻成年人及其母亲。通过实验室多导睡眠图确定 22 岁时的 OSA。采用逻辑回归来确定与年轻成年人 OSA 相关的母亲和新生儿因素。
20.8%（192 人）的参与者存在 OSA。OSA 的母亲相关预测因素包括妊娠期糖尿病（比值比（OR）9.54，95%置信区间（CI）1.7，58.5，P=0.011）、早产（OR 3.18，95%CI 1.1，10.5，P=0.043）、子痫前期（OR 2.95，95%CI 1.1，8.0，P=0.034）、胎膜早破（OR 2.46，95%CI 1.2，5.2，P=0.015）、母亲年龄≥35 岁（OR 2.28，95%CI 1.2，4.4，P=0.011）、超重和肥胖（妊娠 BMI≥25kg/m）（OR 2.00，95%CI 1.2，3.2，P=0.004）、妊娠高血压（OR 1.89，95%CI 1.1，3.2，P=0.019）和华裔（OR 2.36，95%CI 1.01，5.5，P=0.047）。新生儿相关预测因素包括男婴（OR 2.10，95%CI 1.5，3.0，P<0.0001）、分娩时羊水粪染（OR 1.60，95%CI 1.0，2.5，P=0.044）和入住新生儿特别护理病房（OR 1.51，95%CI 1.0，2.2，P=0.040）。出生长度每增加 1 厘米，OSA 的可能性就会降低 7%（OR 0.93，95%CI 0.87，0.99，P=0.033）。
一系列母亲和新生儿因素可预测年轻成年人发生 OSA，包括与母亲代谢健康不良、高危妊娠和围产期应激事件相关的因素。这些信息可以帮助早期识别和管理高危人群，并表明改善母亲健康可能会降低年轻成年人发生 OSA 的可能性。
