Early life predictors of obstructive sleep apnoea in young adults: Insights from a longitudinal community cohort (Raine study)

• Published in: Sleep medicine Vol. 110; pp. 76 - 81
• Main Authors: Ohn, Mon, McArdle, Nigel, Khan, R. Nazim, von Ungern-Sternberg, Britta S., Eastwood, Peter R., Walsh, Jennifer H., Wilson, Andrew C., Maddison, Kathleen J.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.10.2023
• Subjects: Early-life predictors; Maternal health; OSA; Raine study; Young adult; Raine study; OSA; Maternal health; Early-life predictors; Young adult
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2023.07.032

Early-life obstructive sleep apnoea (OSA) predictors are unavailable for young adults. This study identifies early-life factors predisposing young adults to OSA. This retrospective study included 923 young adults and their mothers from the Western Australian Pregnancy Raine Study Cohort. OSA at 22 years was determined from in-laboratory polysomnography. Logistic regression was used to identify maternal and neonatal factors associated with OSA in young adulthood. OSA was observed in 20.8% (192) participants. Maternal predictors of OSA included gestational diabetes mellitus (odds ratio (OR) 9.54, 95% confidence interval (CI) 1.7, 58.5, P = 0.011), preterm delivery (OR 3.18, 95%CI 1.1,10.5, P = 0.043), preeclampsia (OR 2.95, 95%CI 1.1,8.0, P = 0.034), premature rupture of membranes (OR 2.46, 95%CI 1.2, 5.2, P = 0.015), age ≥35 years (OR 2.28, 95%CI 1.2,4.4, P = 0.011), overweight and obesity (pregnancy BMI≥25 kg/m2) (OR 2.00, 95%CI 1.2,3.2, P = 0.004), pregnancy-induced hypertension (OR 1.89, 95%CI 1.1,3.2, P = 0.019), and Chinese ethnicity (OR 2.36,95%CI 1.01,5.5, P = 0.047). Neonatal predictors included male child (OR 2.10, 95%CI 1.5,3.0, P < 0.0001), presence of meconium-stained liquor during delivery (OR 1.60, 95%CI 1.0,2.5, P = 0.044) and admission to special care nursery (OR 1.51 95%CI 1.0,2.2, P = 0.040). Higher birth lengths reduced OSA odds by 7% for each centimetre (OR 0.93, 95%CI 0.87, 0.99, P = 0.033). A range of maternal and neonatal factors predict OSA in young adults, including those related to poor maternal metabolic health, high-risk pregnancy and stressful perinatal events. This information could assist in the early identification and management of at-risk individuals and indicates that better maternal health may reduce the likelihood of young adults developing OSA. •Early-life factors predict OSA in young adults (20.8% prevalence).•Maternal predictors: gestational diabetes, preterm delivery, preeclampsia, obesity.•Neonatal predictors: male, meconium-stained liquor, special care nursery admission.•Longer birth lengths decrease young adults OSA odds.•Better maternal health will lower OSA risk in young adults.