Short and long interpregnancy interval and the risk for pediatric obstructive sleep apnea in the offspring

Abstract

Introduction Interpregnancy interval (IPI) is defined as the period between a live birth and the conception of a subsequent fetus. Both short (IPI < 6 months) and long IPI (IPI > 60 months) have been shown to increase the risk for adverse perinatal outcomes, some of which, are known risk factors for obstructive sleep apnea syndrome (OSAS) in the offspring. Aims To study the association between IPI and risk for offspring OSAS, during a follow‐up period of up to 18 years. Study design Population‐based cohort. Subjects In this population‐based cohort analysis, all singleton live births, born to a mother with at least one previous birth occurring between 1991 and 2014, were included. Congenital malformations were excluded. Materials and Methods Hospitalizations of the offspring due to OSAS diagnosis up to 18 years of age, were evaluated according to IPI length. Intermediate IPI (6–60 months) was considered as the reference. A Kaplan‐Meier survival curve and a Cox hazards regression model were used to compare the incidence of OSAS between the groups, and to adjust for confounding variables. Results The study population included 144,397 deliveries, of which 13.1% (n = 18,947) were followed by short IPI, 7.9% (n = 11,438) and 79.0% (n = 114,012) were followed by long and intermediate IPI, respectively. OSAS hospitalization rates were significantly higher among the long IPI group compared to intermediate and short IPIs (0.9%; 0.7% and 0.6%, respectively, p = .001). The association between long IPI and offspring pediatric OSAS remained significant after controlling for preterm delivery, maternal diabetes, and smoking, and mode of delivery, (adjusted HR = 1.45; 95% CI, 1.17–1.80). Conclusions Children born following long IPI are at increased risk for pediatric OSAS.

Insights into Pediatric Sleep Disordered Breathing: Exploring Risk Factors, Surgical Interventions, and Physical and Scholastic Performance at Follow-Up

“…Additionally, Tan et al reported that children whose mothers were exposed to smoke during pregnancy had a 2.6-fold increase in their risk of developing OSAS [50]. Rapaport Pasternak et al have also reported similar results [51].…”

The association between the interdelivery interval and early postpartum urinary incontinence in women who had consecutive vaginal deliveries: a retrospective cohort study

“…Both short and long IDIs appear to be associated with increased risks of adverse maternalfetal outcomes, including preterm delivery (24), small-forgestational-age birth (25), and infant mortality (26)(27)(28)(29). Clinical postpartum practice and public health guidelines recommend an IDI of at least 18 to 24 months and no more than 60 months (19,(30)(31)(32). However, in relation to postpartum pelvic floor disorders in women, there is a lack of evidence to support the views expressed in the guidelines.…”