560 Infant OSA: Impact on Growth and Development Outcomes

Abstract

\n \n \n Obstructive sleep apnea (OSA) related growth and developmental deficits were previously described in young children. However, growth and development outcomes of OSA in infants is not as clear.\n \n \n \n We retrospectively reviewed polysomnography (PSGs) of infants 0–12 months of age done at one tertiary care, urban medical center, between 2012–2019. Indications for the studies were symptoms or high risk for OSA. Diagnosis of OSA was determined when obstructive apnea hypopnea index (oAHI) >1/hr. Demographic information and physician diagnosed developmental and growth delays were collected from medical records.\n \n \n \n A total of 83 infants were included, mean age was 4.4months (6 days-12 months). Mean baseline oAHI was 16.8/hr (1–91.46/hr). 23 patients were noted to have failure to thrive (27.7%), 27 patients had general developmental delay (32.5%), 22 patients had speech delay (26.5%), and 9 patients had motor delay (10.8%). Out of all the patients with any form of delay (N=46), 39.13% were premature, 71.73% had an underlying neurologic abnormality and 39.13% had some other underlying diagnosed syndrome. 2 patients had delay but no associated comorbidity. Patients without any developmental delay showed trend towards likelihood of more severe OSA compared to patients with any delay (p=0.0455).\n \n \n \n Infant OSA is a separate entity from pediatric OSA and requires a better understanding of its association with developmental outcomes. Infants are particularly vulnerable to obstructive sleep-disordered breathing related to their upper airway anatomy, adverse pulmonary mechanics and a REM-predominant sleep state distribution. We describe a cohort of 83 infants undergoing PSGs in their 1st year of life with developmental and growth follow up until 2nd year of life. Most of the infants with moderate to severe OSA had some delay in their development. Infants without diagnosed delay, were less likely to have severe OSA. It remains unclear to what degree OSA is responsible for these findings as opposed to pre-existing comorbidities. Additional prospective, controlled studies with standardized developmental assessments are warranted to assess causality.\n Support (if any):\n