Risk Factors of Obstructive Sleep Apnea (OSA) in Pediatric Patients: A Systematic Review and Meta-analysis

Introduction: This review aimed to assess the risk factors of Obstructive Sleep Apnea (OSA) in pediatric children, a common condition with serious long-term sequela. Methods: PubMed, CENTRAL, Scopus, and Google Scholar were searched using the keywords " Apnea " , " Obstructive Sleep" " OR " Obstructive Sleep Apnea Syndrome" " AND " Child " OR " Children " OR " Pediatrics " . Data from 35 studies involving 497,688 pediatric patients diagnosed with OSA using polysomnography were reviewed. Risk factors examined included sex, obesity, neck circumference, tonsillar/adenoid hypertrophy, respiratory infections, nasal stenosis, parental OSA/smoking, ethnicity, pre- term birth, and breastfeeding history. Relative Risk (RR) with 95% Confidence fi dence Intervals (95% CI) were calculated, using Cochrane Q and I-2 statistics to estimate heterogeneity. Results: Tonsillar hypertrophy (RR = 3.55), adenoid hypertrophy (RR = 1.63), respiratory tract infection (RR = 2.59), obesity (RR = 1.74), and family history of OSA (RR = 3.03) were signifi- fi- cantly associated with pediatric OSA. White ethnicity was protective (RR = 0.77). Discussion: Recognizing these risk factors aids in early diagnosis and treatment of pediatric OSA. J Pediatr Health Care. (2024) 38, 717 - 726