• Pediatric research · Jul 2016

    Clinical associations of immature breathing in preterm infants: part 1-central apnea.

    • Karen Fairchild, Mary Mohr, Alix Paget-Brown, Christa Tabacaru, Douglas Lake, John Delos, Joseph Randall Moorman, and John Kattwinkel.
    • Department of Pediatrics, The University of Virginia School of Medicine, Charlottesville, Virginia.
    • Pediatr. Res. 2016 Jul 1; 80 (1): 21-7.

    BackgroundApnea of prematurity (AOP) is nearly universal among very preterm infants, but neither the apnea burden nor its clinical associations have been systematically studied in a large consecutive cohort.MethodsWe analyzed continuous bedside monitor chest impedance and electrocardiographic waveforms and oxygen saturation data collected on all neonatal intensive care unit (NICU) patients <35 wk gestation from 2009 to 2014 (n = 1,211; >50 infant-years of data). Apneas, with bradycardia and desaturation (ABDs), defined as central apnea ≥10 s associated with both bradycardia <100 bpm and oxygen desaturation <80%, were identified using a validated automated algorithm.ResultsNumber and duration of apnea events decreased with increasing gestational age (GA) and postmenstrual age (PMA). ABDs were more frequent in infants <31 wk GA at birth but were not more frequent in those with severe retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), or severe intraventricular hemorrhage (IVH) after accounting for GA. In the day before diagnosis of late-onset septicemia and necrotizing enterocolitis, ABD events were increased in some infants. Many infants continued to experience short ABD events in the week prior to discharge home.ConclusionFrequency of apnea events is a function of GA and PMA in infants born preterm, and increased apnea is associated with acute but not with chronic pathologic conditions.

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