Introduction: Despite emerging data that suggest a high frequency and severity of obstructive sleep apnea (OSA) among patients with cystic fibrosis (CF), few of them are referred for polysomnography. Little is known about which patients with CF are at increased risk for OSA and which sleep symptoms merit investigation. Methods: A single-center retrospective analysis of clinical and polysomnographic data from 2009, January 1 to October 31, 2020 in referred children and adults with CF.Results: Among 74 patients (42 children, 32 adults) with CF, 39 (53%) had OSA. No age or sex differences emerged in OSA frequency. Mean apnea-hypopnea index (AHI) was higher among overweight/obese adults (n = 16) as compared with adults of normal weight or underweight (11.4 vs. 6.2; p = 0.005). Adults with (n = 10) versus without a crowded oropharynx had 13.0 times greater odds of OSA (95% confidence interval (CI): 1.4, 121.4; p = 0.02). Children with (n = 24) versus without tonsillar hypertrophy had a higher risk for OSA (OR = 5.2; 95% CI: 1.4, 19.8; p = 0.02), as did children with (n = 10) versus without symptomatic chronic sinusitis (OR = 5.8; 95% CI: 1.1, 32.1; p = 0.04). Neither snoring, excessive daytime sleepiness, nor lung disease severity were associated with OSA. Conclusion:Key risk factors for OSA may differ between children and adults with CF: upper airway pathology appears important in children and overweight/obesity or a crowded oropharynx in adults. Given the lack of sensitivity of snoring, daytime sleepiness, and lung disease severity, detection of OSA may require a low threshold for polysomnographic assessment in this vulnerable population.

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INTRODUCTION:Our multidisciplinary “Partnering for the Future” (PFF) clinic cares for birthing people with a mood or substance use disorder, including patients receiving medications for opioid use disorder (MOUD). The purpose of this study was to summarize the neonatal outcomes among infants born to patients receiving MOUD.METHODS:We conducted a retrospective analysis of all patients receiving care in our PFF clinic from January 2019 to August 2021. We excluded patients who were not maintained on MOUD and those only seen for consultation. Neonatal characteristics were abstracted from the medical record. Descriptive statistics were computed in SPSS v27. This study was deemed exempt by the institutional review boardRESULTS:A total of 92 maternal-infant pairs were identified, of whom 49 patients were taking MOUD, resulting in 51 (54.3%) opioid-exposed infants (two twin pregnancies). Methadone exposure occurred in 21 (43%) pregnancies and buprenorphine exposure in 28 (57%). Neonatal intensive care unit (NICU) admission occurred in 45% (23/51) of infants. Neonatal opioid withdrawal syndrome (NOWS) was diagnosed in 26 (51.0%) infants, with 69% (18/26) infants developing severe NOWS meeting criteria for treatment. Severe NOWS occurred in 57% (12/21) of methadone-exposed pregnancies and 21% (6/28) of buprenorphine-exposed pregnancies. Among the 18 neonates diagnosed with severe NOWS, the average time to initial NOWS diagnosis was 22.35 (±0.86) hours compared to 40.4 (±0.70) hours for neonates diagnosed with non-severe NOWS.CONCLUSION:Severe NOWS was more prevalent among infants exposed to methadone and diagnosed sooner than non-severe NOWS cases. Strategies are needed to reduce NICU admissions and identify infants at highest risk for severe NOWS.

gestational age (GA) of 39 weeks decreased the risk of cesarean delivery (CD). We assessed the rate of elective IOL and CD rates post-ARRIVE in the U.S. METHODS:The 2018-2020 U.S. Vital Statistics birth certificate database was used. Nulliparous, singleton, low-risk pregnancies at 39 weeks of gestation or greater were included. Data was analyzed by county and quarter, including counties with more than 100 births in all quarters.

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