281 - Sleep-Disordered Breathing in Extremely Preterm Infants Before and After Hospital Discharge

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 281
Publication Number: 281.341

Colm P. Travers, University of Alabama School of Medicine, Birmingham, AL, United States; Arie Nakhmani, University of Alabama at Birmingham, Birmingham, AL, United States; Robert Bradley. Troxler, University of Alabama at Birmingham, Birmingham, AL, United States; Rachel L. Benz, University of Alabama at Birmingham, Birmingham, AL, United States; Ammar S. Saadoon Alishlash, UAB, Birmingham, AL, United States; William T.. Harris, University of Alabama School of Medicine, Birmingham, AL, United States; Waldemar A. Carlo, University of Alabama School of Medicine, Birmingham, AL, United States; Namasivayam Ambalavanan, University of Alabama School of Medicine, Birmingham, AL, United States

Presenting Author(s)

Colm P. Travers, MD

Assistant professor
University of Alabama School of Medicine
Birmingham, Alabama, United States

Background: Abnormal control of breathing among extremely preterm infants improves with increasing gestational age and postmenstrual age (PMA). Sleep disordered breathing is common among extremely preterm infants in later childhood but there are limited data from polysomnographic (sleep) studies before and after initial hospital discharge.

Objective: To test the hypothesis that the apnea-hypopnea index (AHI) will decrease from 36 weeks’ PMA compared with 52 weeks’ PMA.

Design/Methods: This single-center observational study included infants from 22-28 weeks’ gestation enrolled in the PreVENT study (NCT03174301) who consented to a formal sleep study at 36 weeks’ and 52 weeks’ PMA. Sleep studies were conducted at the Pediatric Sleep Disorders Center at Children’s of Alabama and interpreted by a board-certified pulmonology and sleep medicine specialist. The primary outcome was the difference in AHI between 36- and 52-weeks’ PMA. Independent data were analyzed by Student’s t-test and Mann-Whitney U test using a 0.05 significance level.

Results: There were 53 infants who completed sleep studies of whom 45 were conducted at 36 weeks’ PMA and 29 were conducted at 52 weeks’ PMA as follow-up was limited by COVID restrictions. There were sixteen infants who completed testing at both 36- and 52-weeks’ PMA. The mean ± SD gestational age was 26w 1d ± 11d and the birth weight was 814 ± 235 grams. AHI decreased from 36- to 52-weeks’ PMA (19 ± 16 versus 4 ± 3; p< 0.001). Episodes of obstructive sleep apnea (15 ± 19 versus 3 ± 5; p< 0.001) and hypopnea (38 ± 44 versus 10 ± 10; p< 0.001) were significantly higher at 36- compared with 52-weeks’ PMA but the difference in central sleep apnea was not significant (30 ± 54 versus 11 ± 11; p=0.07). The mean oxygen saturation (SpO₂) (95 ± 2 versus 98 ± 2; p< 0.001) and minimum SpO₂ level was lower at 36- compared with 52-weeks’ PMA (82 ± 15 % versus 90 ± 5 %; p< 0.01). Carbon dioxide levels did not differ between groups.

Conclusion(s): AHI and other measures of sleep disordered breathing improved from 36- to 52-weeks’ PMA among very preterm infants.