Abstract
The progressive decrease in the periodic cycle duration (PCD) of periodic breathing with postnatal age in term infants has been previously reported by a number of authors and is thought to be associated with peripheral chemoreceptor maturation. We hypothesized that a similar decrease should be observed in preterm infants. Therefore, in this study we measured the changes in PCD with postnatal age in a small group of preterm (n = 4) infants followed longitudinally (36 afternoon nap studies) over the first 6 mo postnatally. PCD declined in these infants from 17.1 ± 3.3 s (mean ± 2 SD) at 9 d to 9.8 ± 3.2 s (mean ± 2 SD) at 105 d. The regression slope was −0.072 s/d. Beyond 105 d there was no change in PCD up to 6 mo postnatally. We found no significant difference between active and quiet sleep. These results are similar to results previously published in term infants but apparently contradict recent data on a group of preterm infants. Possible reasons for this discrepancy are discussed. By examining long epochs of periodic breathing in these infants we also identified characteristic changes in PCD and V/A ratio, defined as the duration of the ventilatory period divided by the duration of the apneic interval. V/A ratio fell from the start of an epoch from 1.21 ± 0.08 (mean ± SEM) to a minimum of 0.62 ± 0.03 and then increased again to 0.8 ± 0.05 at the end of the epoch. We conclude that important maturational changes occur in the neonatal respiratory control system during the first 6 mo postnatally and that these changes are reflected in a fall in PCD of periodic breathing over this period. We also conclude that the characteristic changes which occur in V/A ratio and PCD are consistent with a role for chemical stimuli in the genesis of periodic breathing.
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Wilkinson, M., Cranage, S., Berger, P. et al. Changes in the Temporal Structure of Periodic Breathing with Postnatal Development in Preterm Infants. Pediatr Res 38, 533–538 (1995). https://doi.org/10.1203/00006450-199510000-00010
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DOI: https://doi.org/10.1203/00006450-199510000-00010
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