Abstract 1061 Poster Session IV, Tuesday, 5/4 (poster 364)

Apnea of Prematurity (AoP) is, in part, a reflection of brainstem (BS) maturation. BS maturation may also be evaluated by the progression of the auditory brainstem evoked response (ABR). We previously demonstrated reversible changes in brainstem function (bilirubin encephalopathy, BE) as evaluated by ABR in infants 28-32 wk gestational age (GA) with hyperbilirubinemia. We postulated that as bilirubin increases and transient ABR abnormalities occur, the likelihood of AoP will increase in this population. We studied 100 28-32 wk GA infants and identified 66 with normal and 34 with abnormal ABR progression related to hyperbilirubinemia. Bilirubin encephalopathy was identified on day 3 (median; range 1-6d). A blinded, retrospective chart review identified apnea and bradycardia events in the first week, duration of caffeine/theophylline treatment, duration of mechanical ventilation, CPAP, and/or nasal cannula, and risk factors for apnea (Sepsis, IVH grade ≥ II, asphyxia). Because mechanical ventilation confounds the identification of apnea, infants requiring mechanical ventilation were excluded from further review (n=60). There was no difference in risk factors between groups. Patients with BE had significantly more apneic events, bradycardic events, and required more prolonged treatment with CPAP, Nasal cannula and methylxanthines than those with normal ABR progression (Table, mean ± SD). We conclude that premature infants with transient bilirubin encephalophaty as defined by abnormal ABR progression have more concurrent apneic events and require more prolonged respiratory support and medications.

Table 1 No caption
Full size table