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Children with a history of prematurity presenting with snoring and sleep-disordered breathing: a cross-sectional study.
Laryngoscope. 2013 Aug; 123(8):2030-4.L

Abstract

OBJECTIVES/HYPOTHESIS

To report on the prevalence of premature (PM) birth in a consecutive series of children treated for snoring and sleep-disordered breathing (S/SDB), the parameters specific to their management and variables predictive of disease severity.

STUDY DESIGN

A retrospective study was undertaken at a tertiary pediatric hospital.

METHODS

Children with history of PM and presenting with S/SDB were identified from a prospectively kept surgical database. We set out to determine the prevalence of PM among the patients presenting with S/SDB who required airway evaluations and surgery. Pulse oximetry is overnight recordable oxygen saturation and heart rate tracing that provides information about hypoxemia during sleep. This was performed on all children preoperatively. The pulse oximetry findings were used to plan for perioperative monitoring and care. A multivariable analysis was used to identify factors predictive of abnormal pulse oximetry studies. We evaluated the associated diagnoses, surgical procedures required, and response to treatment in these selected children.

RESULTS

Fifty-seven out of 1,038 patients were PM (33 males; mean age, 62.09 ± 34.91 months; range, 4-190 months). The mean gestational age was 30.3 ± 4.0 weeks. The prevalence rate of PM among patients treated surgically for SDB is 5.5% (95% CI 5.2-5.8) at our center. Comorbid pulmonary and gastrointestinal disorders were encountered on 23 (40%) and 17 (29.8%) occasions, respectively, and were the most commonly encountered comorbid diagnostic categories. Large airway abnormalities were encountered in 11 (19.3%) children, and the most common were subglottic stenosis (four) and laryngeal paralysis (four). Comorbid respiratory disease was negatively predictive of abnormal pulse oximetry (coefficient -0.35, P<.05). Postoperative respiratory outcomes correlated with abnormal pulse oximetry (coefficient 0.3; P<.05).

CONCLUSIONS

Our findings suggest children with PM presenting to pediatric otolaryngology require a comprehensive evaluation for S/SDB. A significant proportion of children with S/SDB and a history of PM frequently had pulmonary and gastrointestinal comorbidities in our cohort. One-half required admission postoperatively, and these were predictable based on preoperative pulse oximetry. Respiratory comorbidity was negatively predictive of severity of SDB. Inversely, children with untreated pulmonary comorbidities are more likely to have postoperative complications.

Authors+Show Affiliations

Division of Otolaryngology Head & Neck Surgery, Department of Surgery, The Stollery Children's Hospital, The University of Alberta Hospitals, Edmonton, Alberta, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23606206

Citation

Manuel, Anura, et al. "Children With a History of Prematurity Presenting With Snoring and Sleep-disordered Breathing: a Cross-sectional Study." The Laryngoscope, vol. 123, no. 8, 2013, pp. 2030-4.
Manuel A, Witmans M, El-Hakim H. Children with a history of prematurity presenting with snoring and sleep-disordered breathing: a cross-sectional study. Laryngoscope. 2013;123(8):2030-4.
Manuel, A., Witmans, M., & El-Hakim, H. (2013). Children with a history of prematurity presenting with snoring and sleep-disordered breathing: a cross-sectional study. The Laryngoscope, 123(8), 2030-4. https://doi.org/10.1002/lary.23999
Manuel A, Witmans M, El-Hakim H. Children With a History of Prematurity Presenting With Snoring and Sleep-disordered Breathing: a Cross-sectional Study. Laryngoscope. 2013;123(8):2030-4. PubMed PMID: 23606206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Children with a history of prematurity presenting with snoring and sleep-disordered breathing: a cross-sectional study. AU - Manuel,Anura, AU - Witmans,Manisha, AU - El-Hakim,Hamdy, Y1 - 2013/04/18/ PY - 2012/02/16/received PY - 2012/07/09/revised PY - 2012/12/25/accepted PY - 2013/4/23/entrez PY - 2013/4/23/pubmed PY - 2013/10/1/medline KW - Prematurity KW - adenotonsillectomy KW - asthma KW - congenital KW - lung disease KW - reflux KW - sleep SP - 2030 EP - 4 JF - The Laryngoscope JO - Laryngoscope VL - 123 IS - 8 N2 - OBJECTIVES/HYPOTHESIS: To report on the prevalence of premature (PM) birth in a consecutive series of children treated for snoring and sleep-disordered breathing (S/SDB), the parameters specific to their management and variables predictive of disease severity. STUDY DESIGN: A retrospective study was undertaken at a tertiary pediatric hospital. METHODS: Children with history of PM and presenting with S/SDB were identified from a prospectively kept surgical database. We set out to determine the prevalence of PM among the patients presenting with S/SDB who required airway evaluations and surgery. Pulse oximetry is overnight recordable oxygen saturation and heart rate tracing that provides information about hypoxemia during sleep. This was performed on all children preoperatively. The pulse oximetry findings were used to plan for perioperative monitoring and care. A multivariable analysis was used to identify factors predictive of abnormal pulse oximetry studies. We evaluated the associated diagnoses, surgical procedures required, and response to treatment in these selected children. RESULTS: Fifty-seven out of 1,038 patients were PM (33 males; mean age, 62.09 ± 34.91 months; range, 4-190 months). The mean gestational age was 30.3 ± 4.0 weeks. The prevalence rate of PM among patients treated surgically for SDB is 5.5% (95% CI 5.2-5.8) at our center. Comorbid pulmonary and gastrointestinal disorders were encountered on 23 (40%) and 17 (29.8%) occasions, respectively, and were the most commonly encountered comorbid diagnostic categories. Large airway abnormalities were encountered in 11 (19.3%) children, and the most common were subglottic stenosis (four) and laryngeal paralysis (four). Comorbid respiratory disease was negatively predictive of abnormal pulse oximetry (coefficient -0.35, P<.05). Postoperative respiratory outcomes correlated with abnormal pulse oximetry (coefficient 0.3; P<.05). CONCLUSIONS: Our findings suggest children with PM presenting to pediatric otolaryngology require a comprehensive evaluation for S/SDB. A significant proportion of children with S/SDB and a history of PM frequently had pulmonary and gastrointestinal comorbidities in our cohort. One-half required admission postoperatively, and these were predictable based on preoperative pulse oximetry. Respiratory comorbidity was negatively predictive of severity of SDB. Inversely, children with untreated pulmonary comorbidities are more likely to have postoperative complications. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/23606206/Children_with_a_history_of_prematurity_presenting_with_snoring_and_sleep_disordered_breathing:_a_cross_sectional_study_ L2 - https://doi.org/10.1002/lary.23999 DB - PRIME DP - Unbound Medicine ER -