Objective/Hypothesis: Studies have suggested preterm birth, defined as gestational age (GA) <37 weeks, is a risk factor for obstructive sleep apnea (OSA) in later childhood. However, little is known about the characteristics, severity, and degree of intervention of childhood OSA in former preterm infants compared to term infants. This study compares polysomnographic characteristics and surgical interventions in former preterm and term infants presenting with sleep disordered breathing.Study Design: Retrospective cohort study from 2015 to 2019 at a single tertiary referral center. Methods: Electronic Medical Records of pediatric patients ages 0 to 18 presenting with sleep disordered breathing were reviewed for gestational age, polysomnographic findings, clinical characteristics, and OSA surgical interventions. Association between gestational age, polysomnographic characteristics, and surgical interventions for OSA were reported.Results: A total of 615 patient records were analyzed. Adjusting for covariates, prematurity was associated with a 2.97× higher likelihood of development of severe OSA (aOR (95%CI): 2.97 (1.40-6.32)), increased apneic-hypoxic index (AHI) (mean (SD): 6.5 (9.8) vs. 4.6 (6.4), P < .05), increased end tidal CO 2 (50.5 (5.11) vs. 48.5 (5.8), P < .05), decreased REM latency (116 (64.7) vs. 132.4 (69.9), P < .05), and increased number of surgeries for OSA (0.65 (.95) vs. 0.45 (0.69), P < .05) compared to children born at term. Children born with GA < 32 weeks presented at a significantly later age with sleep disordered breathing (7.04 (.80) vs. 5.1 (0.15), P < .05) than children born at term.Conclusions: Prematurity was associated with increased likelihood of severe OSA, increased AHI, as well as increased number of surgical interventions for OSA compared to children born at term. These results suggest an association with preterm birth and increased severity of childhood OSA.
Expressive writing (EW) can be an effective way to alter maladaptive emotional reactions to stressful life events, although little is known about how pre-adolescents may benefit from it. In this quasi-experimental study, we compared measures of depression, anger, forgiveness, positive and negative affect in pre-adolescents before and after EW in both an experimental group undergoing the EW paradigm and a control group (N=138). No significant effects between control and experimental groups were found for the considered variables, except for positive and negative affect. We suggest potential reasons accounting for these results. Given that the theorised mechanisms involved in the EW paradigm include executive functioning abilities, it is possible that preadolescents may not be able to benefit from it, due to not fully developed executive functioning skills. Our results provide useful information in order to better design future studies and prevention/intervention programmes to be implemented with preadolescents. Key words: Expressive Writing, Pre-adolescents, Depression, Anger, Forgiveness
ResumenLa Escritura Expresiva (EE) puede ser una forma efectiva de alterar reacciones emocionales maladaptativas a eventos estresantes de la vida, aunque se sabe poco sobre cómo los pre-adolescentes pueden beneficiarse de ella. En este estudio cuasi-experimental, comparamos medidas de depresión, ira, perdón, afecto positivo y negativo en pre-adolescentes antes y después de EE en un grupo experimental sometido al paradigma de EE y en un grupo de control (N=138). No se encontraron efectos significativos entre los grupos control y experimental para las variables consideradas, excepto para los afectos positivos y negativos. Sugerimos posibles razones para explicar estos resultados. Dado que los mecanismos teóricos implicados en el paradigma de la EE incluyen las capacidades de funcionamiento ejecutivo, es posible que los preadolescentes no puedan beneficiarse de ella, debido a las habilidades de funcionamiento ejecutivo no totalmente desarrolladas. Nuestros resultados proporcionan información útil para un mejor diseño de futuros estudios y programas de prevención / intervención a implementar con preadolescentes.
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