Abstract
Apnea is a major cause of morbidity in VLBW infants (<1500 g BW), both in the NICU and after discharge. To determine the incidence of unexplained apnea (Apnea of Prematurity, AOP) and to assess the relationship between a history of AOP and the presence of respiratory pattern abnormalities at NICU discharge, we reviewed the records of 147 VLBW infants admitted to our 3 NICUs in 7/82 through 6/83. Mean BW(±SD) was 1130±220 g and gestational age was 29.8±2 wks. Symptomatic apnea, defined as > 1 episode of >20 sec duration or, if less, associated with bradycardia or color change, occurred in 104/147 (71%) of this VLBW group. Eighty-four (81%) of these patients had unexplained apnea or AOP. The incidence of AOP was greater in the <1250 g BW group (72% vs 44%, p<.01) and did not progressively increase with decreasing BW or GA, <1250 g or <32 wks. Predischarge pneumograms were obtained in 104/147 infants off Theophylline therapy at a mean postnatal age of 60±28 days. Results of longest apnea(sec), periodic breathing episodes/100 min and apena density(A6/D%) in the AOP infants were compared with non-AOP infants and a group of normal term infants' pneumograms done at 1 month of age. The only significant abnormality noted was an increase in longest apnea in the AOP group compared to the non-AOP group (11±6 sec vs 8±3 sec, p<.05), and compared to the term infants as well (11±6 sec vs 7.6±3 sec, p<.01).
In summary, apnea was unexplained in 81% of VLBW infants, but a history of AOP does not predict which infants will have respiratory pattern abnormalities at NICU discharge.
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Holmes, D., Suchy, S., Hunt, C. et al. 1414 EARLY AND LATE APNEA IN VERY LOW BIRTHWEIGHT (VLBW) INFANTS. Pediatr Res 19, 346 (1985). https://doi.org/10.1203/00006450-198504000-01438
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DOI: https://doi.org/10.1203/00006450-198504000-01438