1. Sleep-related breathing disorders in infants with spina bifida repaired prenatally and postnatally.
- Author
-
Stark KG, Wang RY, Smith KA, Chu J, Keens TG, Van Speybroeck A, Chmait RH, Davidson Ward SL, and Perez IA
- Subjects
- Humans, Retrospective Studies, Female, Male, Infant, Infant, Newborn, Sleep Apnea Syndromes surgery, Pregnancy, Ventriculoperitoneal Shunt methods, Ventriculoperitoneal Shunt statistics & numerical data, Meningomyelocele surgery, Meningomyelocele complications, Arnold-Chiari Malformation surgery, Arnold-Chiari Malformation complications, Treatment Outcome, Spinal Dysraphism surgery, Spinal Dysraphism complications, Polysomnography methods, Polysomnography statistics & numerical data
- Abstract
Study Objectives: Advances in prenatal repair of myelomeningocele have improved outcomes involving different organ systems. There are limited data on respiratory outcomes following prenatal surgical repair. We hypothesize there is no difference in respiratory outcomes between patients with spina bifida who have undergone prenatal vs postnatal repair., Methods: We performed a retrospective study of 46 infants < 1 year with spina bifida seen at Children's Hospital Los Angeles from 2004-2022. Demographic data, timing of closure, neonatal course, Chiari II malformation, ventriculoperitoneal shunt, polysomnography results, and need for supplemental oxygen were collected. Unpaired t test and χ
2 test were used to analyze results., Results: A total of 31/46 had prenatal repair of myelomeningocele; average age at repair was 27 weeks postconception. Average age at postnatal repair was 37 weeks postconception. There was no difference in age at polysomnography. There was no difference in Chiari II malformation presence ( P = .61). Sixty pecent of patients with postnatal repair and 23% in the prenatal group underwent ventriculoperitoneal shunt placement ( P = .01). There was no difference in polysomnography findings between the 2 groups: central apnea index ( P = .11), obstructive apnea-hypopnea index ( P = .64), average oxygen saturation baseline ( P = .91), average oxygen saturation nadir ( P = .17), average end-tidal carbon dioxide baseline ( P = .87), and average end-tidal carbon dioxide maximum ( P = .54). There were no significant differences in the proportion of patients on supplemental oxygen ( P = .25), central sleep apnea or obstructive sleep apnea between groups., Conclusions: Patients with spina bifida who have undergone closure of neural tube defect have persistent central apneas, obstructive apneas, and significant hypoxemia. There were no differences in the frequency or severity of sleep-disordered breathing in those with prenatal repair vs postnatal repair., Citation: Stark KG, Wang RY, Smith KA. Sleep-related breathing disorders in infants with spina bifida repaired prenatally and postnatally. J Clin Sleep Med . 2024;20(10):1579-1583., (© 2024 American Academy of Sleep Medicine.)- Published
- 2024
- Full Text
- View/download PDF