title: Perinatal Risk Factors Associated with the Obstructive Sleep Apnea Syndrome in School-Aged Children Born Preterm.
abstract: OBJECTIVE
  The obstructive sleep apnea syndrome (OSAS) is more prevalent in ex-preterm children compared to the general pediatric population. However, it is unknown whether OSAS in ex-preterm children is associated with specific perinatal risk factors. This multicenter cohort study aimed to determine perinatal factors associated with OSAS at school age.
  
  
  METHODS
  197 ex-preterm (500-1,250 g) children aged 5-12 y who participated as neonates in a double-blind, randomized clinical trial of caffeine versus placebo (Caffeine for Apnea of Prematurity) underwent comprehensive ambulatory polysomnography. A negative binomial regression model was used to identify perinatal risk factors associated with OSAS.
  
  
  RESULTS
  19 children had OSAS (9.6%). Chorioamnionitis and multiple gestation were positively associated with OSAS with P values of 0.014 and 0.03, respectively. Maternal white race (P = 0.047) and maternal age (P = 0.002) were negatively associated with OSAS. Other risk factors, such as birth weight, Apgar score at 5 min, antenatal corticosteroids, delivery route, and sex were not significant.
  
  
  CONCLUSIONS
  OSAS is very frequent, and is associated with chorioamnionitis and multiple gestation in ex-preterm children. Those born to older white mothers appear to be protected. We speculate that the former may be due to systemic inflammation and the latter to a higher socio-economic status.
  
  
  CONCLUSIONS
  A commentary on this article appears in this issue on page 721.
authors.affiliation: Sleep Center, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Ignacio E
authors.initials: IE
authors.lastname: Tapia
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania.
authors.forename: Justine
authors.initials: J
authors.lastname: Shults
authors.affiliation: Department of Obstetrics and Gynaecology, Royal Women's Hospital, Melbourne, Australia.
authors.forename: Lex W
authors.initials: LW
authors.lastname: Doyle
authors.affiliation: Melbourne Children's Sleep Centre, Monash Children's, Monash University, Melbourne, Australia.
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Nixon
authors.affiliation: Sleep Center, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Cielo
authors.affiliation: Sleep Center, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Joel
authors.initials: J
authors.lastname: Traylor
authors.affiliation: Sleep Center, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
authors.forename: Carole L
authors.initials: CL
authors.lastname: Marcus
mesh_terms: D001034:Apgar Score; D001724:Birth Weight; D002110:Caffeine / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002821:Chorioamnionitis; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016014:Linear Models; D008297:Male; D008423:Maternal Age; D017286:Polysomnography; D011247:Pregnancy; D011248:Pregnancy Complications; D011272:Pregnancy, Multiple; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology* / Q000209:etiology*; D012923:Social Class; D044465:White People
chemical_list: D002110:Caffeine
keywords: OSAS; preterm; risk factors; school-aged