Prenatal, Perinatal, and Early Childhood Factors Associated with Childhood Obstructive Sleep Apnea

被引:14
作者
Chen, Ting [1 ]
Hughes, Mary E. [1 ]
Wang, Hongjian [2 ,3 ]
Wang, Guoying [1 ]
Hong, Xiumei [1 ]
Liu, Li [1 ]
Ji, Yuelong [1 ]
Pearson, Colleen [4 ,5 ]
Li, Shenghui [6 ]
Hao, Lingxin [7 ]
Wang, Xiaobin [1 ]
机构
[1] Johns Hopkins Univ, Dept Populat Family & Reprod Hlth, Bloomberg Sch Publ Hlth, E4132,615 North Wolfe St, Baltimore, MD 21205 USA
[2] Chinese Acad Med Sci, Natl Ctr Cardiovasc Dis, Beijing, Peoples R China
[3] Peking Union Med Coll, Beijing, Peoples R China
[4] Boston Univ, Sch Med, Dept Pediat, Boston, MA 02118 USA
[5] Boston Med Ctr, Boston, MA USA
[6] Jiao Tong Univ, Dept Prevent Med, Sch Med, Shanghai, Peoples R China
[7] Johns Hopkins Univ, Hopkins Populat Ctr, Baltimore, MD 21205 USA
基金
美国国家卫生研究院;
关键词
SCHOOL-AGED CHILDREN; RISK-FACTORS; GESTATIONAL-AGE; PLASMA-LEVELS; OBESITY; WEIGHT; BIRTH; LEPTIN; RACE; ADENOTONSILLECTOMY;
D O I
10.1016/j.jpeds.2019.05.053
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objectives To investigate prenatal, perinatal, and early childhood factors, including cord and early childhood plasma leptin, on a clinical diagnosis of obstructive sleep apnea (OSA) among children in the Boston Birth Cohort. Study design We conducted a secondary analysis of 2867 mother-child pairs from the Boston Birth Cohort who were enrolled between 1998 and 2014 at Boston Medical Center and followed from birth to age 16 years. Child's OSA was defined based on clinical diagnoses documented in the medical record. Plasma leptin was measured in cord and early childhood blood samples. Logistic regression was used to examine individual and combined effects of early life factors on the risk of OSA, adjusting for potential confounders. Results The mean age of the study children was 6.39 years (SD = 3.77); 49.3% were girls, and 209 (7.3%) had ever been diagnosed with OSA. Four significant risk factors for OSA were identified: maternal obesity/diabetes during pregnancy (OR, 1.63; 95% CI, 1.21-2.21; P = .001), preterm/low birth weight (OR, 1.74; 95% CI, 1.30-2.32; P < .001), early childhood obesity (OR, 1.89; 95% CI, 1.37-2.62; P < .001), and high leptin levels in early childhood (OR, 1.94; 95% CI, 1.22-3.09; P = .005). The presence of all these 4 risk factors significantly amplified the odds of OSA by about 10 times (OR, 9.95; 95% CI, 3.42-28.93; P < .001) compared with those lacking these factors. Conclusions Our findings, if further confirmed, provide new insight into the early life risk factors of pediatric OSA and underscore the need for early screening and prevention of OSA among children with those risk factors.
引用
收藏
页码:20 / +
页数:18
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