Deng Zhe, Wang Guixiang, Hou Yuwei, Liu Yujie, Xu Yanxia, Xu Ying, Seng Dongjie, Han Fugen, Zhao Jing
Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou,450000,China.
Department of Otolaryngology-Headandneck Surgery,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Mar;38(3):230-234. doi: 10.13201/j.issn.2096-7993.2024.03.010.
To study the relationship between children's birth weight and obstructive sleep apnea(OSA). The sleep data and birth information of children who underwent polysomnography in the Department of Otorhinolaryngology-Head and Neck Surgery of Henan Children's Hospital from October 2020 to July 2022 were retrospectively analyzed. The data of OSA detection rate, OSA severity, sleep structure and respiratory parameters in different birth weight groups were analyzed. A total of 2 778 children met the inclusion criteria, including 1 833 males and 945 females. According to birth weight, the selected children were divided into three groups: 122 small for gestational age(SGA) group, 2 313 appropriate for gestational age(AGA), and 343 large for gestational age(LGA) group. There was no significant difference in age between different groups(=0.061). In each group, boys are significantly more numerous than girls(=0.001). The difference in current body mass index(BMI) between groups was statistically significant: the current BMI was higher in the LGA group(17.51±4.01, <0.001). The severity of OSA was different in different birth weight groups(=0.037). There was a strong positive correlation between the severity of OSA and birth weight(=0.992). Children in the SGA group had shorter rapid eye movement(REM) sleep period(19.00[15.18, 23.33], =0.012), higher obstructive apnea-hypopnea index(OAHI) values(1.75[0.60, 5.13], =0.019), and had lower central apnea hypopnea index(CAHI) values(0.10[0.00, 0.50], =0.020). There were no significant differences in sleep structure and respiratory parameters between the LGA group and the AGA group. Multiple regression analysis of the factors affecting the OAHI index showed that the OAHI index of boys was higher than that of girls(95% 1.311-2.096, <0.001), and age was negatively correlated with the OAHI index(=-0.105, 95% 0.856-0.946, <0.001), current BMI and OAHI index were positively correlated(=0.037, 95% 1.010-1.065, =0.007). LGA was positively correlated with OAHI index(=0.346, 95% 1.039-1.921, =0.027), and the correlation between LGA and OAHI(=0.346) was higher than that between SGA and OAHI(=0.340). There was no significant difference in the incidence of OSA in children with different birth weight groups, but the OSA severity of LGA group was higher. Gender, age, BMI index and large for gestational age were the influencing factors for the occurrence of OSA in children, which should be paid more attention to in clinical practice.
研究儿童出生体重与阻塞性睡眠呼吸暂停(OSA)之间的关系。回顾性分析2020年10月至2022年7月在河南省儿童医院耳鼻咽喉头颈外科接受多导睡眠监测的儿童的睡眠数据和出生信息。分析不同出生体重组的OSA检出率、OSA严重程度、睡眠结构和呼吸参数数据。共有2778名儿童符合纳入标准,其中男性1833名,女性945名。根据出生体重,将入选儿童分为三组:122名小于胎龄(SGA)组、2313名适于胎龄(AGA)组和343名大于胎龄(LGA)组。不同组间年龄差异无统计学意义(=0.061)。每组中,男孩数量均显著多于女孩(=0.001)。组间当前体重指数(BMI)差异有统计学意义:LGA组当前BMI更高(17.51±4.01,<0.001)。不同出生体重组的OSA严重程度不同(=0.037)。OSA严重程度与出生体重呈强正相关(=0.992)。SGA组儿童的快速眼动(REM)睡眠时间较短(19.00[15.18,23.33],=0.012),阻塞性呼吸暂停低通气指数(OAHI)值较高(1.75[0.60,5.13],=0.019),而中枢性呼吸暂停低通气指数(CAHI)值较低(0.10[0.00,0.50],=0.020)。LGA组与AGA组在睡眠结构和呼吸参数方面差异无统计学意义。对影响OAHI指数的因素进行多元回归分析显示,男孩的OAHI指数高于女孩(95% 1.311 - 2.096,<0.001),年龄与OAHI指数呈负相关(=-0.105,95% 0.856 - 0.946,<0.001),当前BMI与OAHI指数呈正相关(=0.037,95% 1.010 - 1.065,=0.007)。LGA与OAHI指数呈正相关(=0.346,95% 1.039 - 1.921,=0.027),且LGA与OAHI的相关性(=0.346)高于SGA与OAHI的相关性(=0.340)。不同出生体重组儿童的OSA发生率差异无统计学意义,但LGA组的OSA严重程度更高。性别、年龄、BMI指数和大于胎龄是儿童OSA发生的影响因素,在临床实践中应予以更多关注。