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Apnoea-hypopnoea index elevated in newborns with myelomeningocele

30 Dec 2017

Newborns with myelomeningocele have significantly higher apnoea-hypopnoea indices (AHI) compared with their healthy counterparts, a recent matched-cohort study shows.

The researchers calculated the AHI for 19 newborns with spina bifida and 19 controls, and found that it was significantly higher in the infants with myelomeningocele than in controls (34.2±21.9 vs 19.3±11.1; p=0.021).

AHI was consistently higher in myelomeningocele patients both in active (52.2±28.0 vs 30.5±19.2; p=0.015) and quiet (27.0±30.0 vs 10.5±8.1; p=0.015) sleep. The hypopnoea index was also significantly higher in those with myelomeningocele than in controls (21.2±14.3 vs 12.4±7.8; p=0.044). Majority of the respiratory events were hypopnoea.

In contrast, both obstructive apnoea index (3.0±3.5 vs 2.5±2.5; p=0.74) and central apnoea index (10.0±17.2 vs 4.4±3.4; p=0.26) were statistically similar between patient groups. Majority of the apnoea episodes were central.

Moreover, while the duration of admission was significantly longer in infants with myelomeningocele than controls (17.3±17.0 vs 7.3±3.9 days; p<0.001), length of stay was not significantly associated with AHI.

In subsequent subgroup analyses, the researchers found that median AHI was not significantly different between the five infants who underwent foetal repair and those who received postnatal repair (29.0 vs 29.6). AHI also did not change significantly according to myelomeningocele level.

Follow-up surveys after 6 months were accomplished by 15 myelomeningocele patients and 11 controls. There were four and two children in the respective groups who showed developmental delays. AHI was not significantly different between those with and without developmental delays (36.0±24.4 vs 29.0±13.1; p=0.78).

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