Early Term Deliveries and the Risk of Pediatric Obstructive Sleep Apnoea in the Offspring.
Preterm delivery may affect the development of the upper airways resulting in a higher risk of obstructive sleep apnoea (OSA). We investigated whether children born at early term (37-38 6/7 weeks' gestation) are at an increased risk for childhood OSA as compared with those born later.



In this population-based cohort analysis all singleton deliveries occurring between 1991-2013 at a single regional tertiary medical centre were included. Gestational age upon delivery was sub-divided into: early preterm (<33 6/7 weeks' gestation), late preterm (34-36 6/7), early term, full term (39-40 6/7), late term (41-41 6/7), and post term (>42 0/7). Incidence of OSA related hospitalizations of the offspring, up to the age of 18 years, was evaluated. A survival curve and a Cox model were used to assess the association.



During the study period 240 953 deliveries met the inclusion criteria. OSA hospitalization (n = 1320) rates decreased as gestational age increased from 1.1% in the early preterm group, 0.8% in late preterm, 0.7% at early term, 0.5% in full term, 0.4% in late term, to 0.3% in post term born children. In the Cox regression, early term delivery exhibited an increased risk for paediatric OSA (adjusted hazard ratio (HR) 1.3 95% Confidence interval (CI) 1.2, 1.5) while late and post term deliveries were associated with significantly lower OSA risk when compared with full term (HR 0.8 95% CI 0.6, 0.9 and HR 0.6 95% CI 0.4, 0.8, respectively).



Early term deliveries are associated with higher rates of paediatric OSA, which decrease gradually as gestational age advances.
Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva, Israel.
Asnat
0000-0002-0201-9691
A
Walfisch
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Tamar
T
Wainstock
Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva, Israel.
Ofer
O
Beharier
Department of Neonatology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Daniella
D
Landau
Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva, Israel.
Eyal
E
Sheiner
D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D005260:Female; D005865:Gestational Age; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D011247:Pregnancy; D047928:Premature Birth; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000209:etiology*
early term pregnancy; long-term; outcome; sleep disordered breathing