Sleep-Disordered Breathing Affects Many Neonates With Myelomeningocele

THURSDAY, Jan. 29, 2026 (HealthDay News) -- Sleep-disordered breathing (SDB) affects more than half of neonates with myelomeningocele, with prematurity independently linked to higher apnea-hypopnea index (AHI), in adjusted models, according to a study published online Jan. 23 in Pediatrics.Renée A. Shellhaas, M.D., from the Washington University School of Medicine in St. Louis, and colleagues examined the frequency of SDB among neonates with fetal versus postnatal myelomeningocele repair in a nine-center, prospective, observational study involving neonates with myelomeningocele born at more than 30 weeks gestational age. The neonates underwent a 10-hour bedside polysomnogram at least 35 weeks postmenstrual age, before hospital discharge, and decisions were made regarding surgical timing (fetal versus postnatal), technique (open fetal versus fetoscopic approach), and SDB treatment.Overall, 92 of the 173 infants (53 percent) had SDB. The researchers found that AHI was higher among the 90 neonates with fetal repair versus the 83 with postnatal surgery in an unadjusted analysis (median, 29 versus 19). Prematurity was independently associated with AHI in propensity-adjusted multivariable models, while surgical timing was not. In adjusted models, hindbrain herniation, myelomeningocele level, and clinical need for ventriculoperitoneal shunt did not predict AHI. Supplemental oxygen was prescribed frequently, for 44 and 39 percent of fetal and postnatal myelomeningocele repair infants."The vast majority of these newborns with breathing problems would have been completely undetected without the comprehensive sleep studies performed by our multidisciplinary research teams before hospital discharge," Shellhaas said in a statement. "This research demonstrates how bringing together expertise from multiple specialties can identify critical but previously overlooked opportunities to improve outcomes for vulnerable infants."Two authors disclosed ties to Eli Lilly & Company.Abstract/Full Text.Sign up for our weekly HealthDay newsletter