Perinatal risk factors for obstructive sleep apnea syndrome in children

Objective: The aim of this study was to determine whether specific perinatal factors are associated with obstructive sleep apnea syndrome (OSAS) in children.

Methods: A retrospective case-control study was conducted. All cases of OSAS were obtained from a tertiary pediatric hospital between April 2013 and April 2016. A total of 823 children who had been diagnosed with OSAS were designated as the case group, and 823 children without OSAS were selected with strict criteria to match with the case group by age, gender and body mass index. Logistic regression models were used to determine the perinatal factors associated with childhood OSAS.

Results: Preterm birth (adjusted odds ratio (aOR): 1.87, 95% confidence interval (CI): 1.13-3.08) and cesarean section (aOR: 1.32, 95% CI: 1.03-1.68) were significantly associated with OSAS. Exposure of the mother to smoke (aOR: 2.59, 95% CI: 1.57-4.26) was also associated with an increased risk of childhood OSAS. Mothers aged 35 years and above, performing manual labor, and living in suburban areas significantly increased the risk of childhood OSAS. Multiparous mothers decreased the risk of childhood OSAS (aOR: 0.59, 95% CI: 0.42-0.83). Maternal education, gravidity, prenatal care times, pregnancy-induced hypertension, multiple pregnancies, sex of the child and birth weight were not significantly associated with OSAS in children.

Conclusion: Perinatal risk factors are important for predicting childhood OSAS. Our findings provide evidence regarding several potentially useful factors for recognizing OSAS in children, which could be important in diagnosis of pediatric OSAS by physicians.