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Sleep-related breathing disorders in infants with spina bifida repaired prenatally and postnatally

Katherine G Stark1, Rachel Y Wang2, Kathryn A Smith2,3

  • 1Neuroscience, Dornsife College of Letters Arts and Science, University of Southern California, Los Angeles, California.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|April 25, 2024
PubMed

Insights

Prenatal repair of myelomeningocele shows no difference in respiratory outcomes compared to postnatal repair. Infants with spina bifida, regardless of repair timing, experience sleep-disordered breathing and hypoxemia.

Area of Science:

  • Pediatric Surgery
  • Neonatal Care
  • Respiratory Medicine

Background:

  • Prenatal repair of myelomeningocele has advanced, but respiratory outcomes data are limited.
  • Spina bifida repair timing may impact various organ systems, necessitating respiratory assessment.

Purpose of the Study:

  • To investigate respiratory outcomes in infants with spina bifida based on prenatal versus postnatal surgical repair.
  • To determine if prenatal repair impacts sleep-disordered breathing or oxygenation compared to postnatal repair.

Main Methods:

  • Retrospective study of 46 infants under 1 year with spina bifida.
  • Collected data on demographics, closure timing, neonatal course, Chiari II malformation, shunts, polysomnography, and oxygen needs.
  • Analyzed data using unpaired t-tests and chi-squared tests.

Main Results:

  • No significant differences in polysomnography findings (apnea indices, oxygen saturation, end-tidal CO2) between prenatal and postnatal repair groups.
  • Similar rates of central and obstructive sleep apnea and supplemental oxygen use were observed.
  • A higher rate of ventriculoperitoneal shunt placement was noted in the postnatal repair group (60% vs. 23%).

Conclusions:

  • Infants with spina bifida repaired prenatally or postnatally exhibit persistent sleep-disordered breathing and hypoxemia.
  • The timing of neural tube defect closure does not appear to influence the frequency or severity of these respiratory issues.
Abstract

Keywords:
fetoscopic repairmyelomeningocelepolysomnographypost-natal repairsleep-disordered breathingspina bifida

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