title: Preterm Versus Term Children: Analysis of Sedation/Anesthesia Adverse Events and Longitudinal Risk.
abstract: OBJECTIVE
  Preterm and former preterm children frequently require sedation/anesthesia for diagnostic and therapeutic procedures. Our objective was to determine the age at which children who are born <37 weeks gestational age are no longer at increased risk for sedation/anesthesia adverse events. Our secondary objective was to describe the nature and incidence of adverse events.
  
  
  METHODS
  This is a prospective observational study of children receiving sedation/anesthesia for diagnostic and/or therapeutic procedures outside of the operating room by the Pediatric Sedation Research Consortium. A total of 57,227 patients 0 to 22 years of age were eligible for this study. All adverse events and descriptive terms were predefined. Logistic regression and locally weighted scatterplot regression were used for analysis.
  
  
  RESULTS
  Preterm and former preterm children had higher adverse event rates (14.7% vs 8.5%) compared with children born at term. Our analysis revealed a biphasic pattern for the development of adverse sedation/anesthesia events. Airway and respiratory adverse events were most commonly reported. MRI scans were the most commonly performed procedures in both categories of patients.
  
  
  CONCLUSIONS
  Patients born preterm are nearly twice as likely to develop sedation/anesthesia adverse events, and this risk continues up to 23 years of age. We recommend obtaining birth history during the formulation of an anesthetic/sedation plan, with heightened awareness that preterm and former preterm children may be at increased risk. Further prospective studies focusing on the etiology and prevention of adverse events in former preterm patients are warranted.
authors.affiliation: The Dartmouth Institute, Lebanon, New Hampshire; jeana.e.havidich@hitchcock.org.
authors.forename: Jeana E
authors.initials: JE
authors.lastname: Havidich
authors.affiliation: The Dartmouth Institute, Lebanon, New Hampshire;
authors.forename: Michael
authors.initials: M
authors.lastname: Beach
authors.affiliation: Riley Children's Hospital Indianapolis, Indiana; and.
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Dierdorf
authors.affiliation: The Dartmouth Institute, Lebanon, New Hampshire;
authors.forename: Tracy
authors.initials: T
authors.lastname: Onega
authors.affiliation: The Dartmouth Institute, Lebanon, New Hampshire;
authors.forename: Gautham
authors.initials: G
authors.lastname: Suresh
authors.affiliation: Boston Children's Hospital, Boston, Massachusetts.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Cravero
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000402:Airway Obstruction / Q000209:etiology; D000758:Anesthesia / Q000009:adverse effects*; D000777:Anesthetics / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D012913:Snoring / Q000209:etiology; D047929:Term Birth; D055815:Young Adult
chemical_list: D000777:Anesthetics; D006993:Hypnotics and Sedatives; D010100:Oxygen