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Pediatric sleep apnea and craniofacial anomalies: A population‐based case–control study
Author(s) -
Lam Derek J.,
Jensen Christine C.,
Mueller Beth A.,
Starr Jacqueline R.,
Cunningham Michael L.,
Weaver Edward M.
Publication year - 2010
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.21093
Subject(s) - craniofacial , medicine , obstructive sleep apnea , odds ratio , pediatrics , confidence interval , logistic regression , population , sleep apnea , case control study , retrospective cohort study , birth certificate , environmental health , psychiatry
Objective: To investigate the association between craniofacial anomalies and diagnosis with obstructive sleep apnea (OSA) in a large, population‐based sample of children. Design: Retrospective case–control study. Methods: Cases of OSA (n = 1,203) were identified by International Classification of Diseases‐9 codes consistent with OSA in the 1987–2003 Washington State inpatient discharge database among children ≤18 years of age and born in Washington state. For each case, five controls without OSA (n = 6,015) were randomly selected from the remaining Washington State births, frequency matched by birth year. Congenital anomaly diagnoses and covariates were extracted from discharge data for all inpatient hospitalizations during the study period and linked birth certificate data. Multiple logistic regression was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) for the associations between congenital anomalies (including subgroups) and OSA. Results: An OSA diagnosis was strongly associated with the presence of any craniofacial anomaly (adjusted OR 38, 95%CI [24, 60]) and, in particular, with orofacial cleft (adjusted OR 40, 95%CI [17, 94]) and Down syndrome (adjusted OR 51, 95%CI [20, 128]). OSA was less associated with any noncraniofacial malformation (adjusted OR 4.1, 95%CI [3.1, 5.3]), which may reflect the relatively small effect of inpatient exposure bias in the associations above. Conclusions: The presence of congenital craniofacial anomalies is strongly associated with inpatient diagnosis of OSA. These findings persist even after control of major potential biases. Parents and clinicians should consider screening for OSA among children with craniofacial anomalies. Laryngoscope, 2010