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Apnea at Discharge and Gastro-Esophageal Reflux in the Preterm Infant

Journal of Perinatology volume 22, pages 8–11 (2002)Cite this article

Abstract

OBJECTIVE: To determine the relationship between respiratory patterns and acid gastro-esophageal reflux (g-e reflux) prior to discharge of the formerly preterm infant.

STUDY DESIGN: Forty-five infants of <32 weeks' gestation were studied at an average postmenstrual age of 37.2 weeks (SD 3.5). Following informed parental consent, a 12-hour multichannel recording including esophageal pH was obtained. Apneas of greater than 10 seconds were recorded, as well as the occurrence of bradycardia or desaturation.

RESULTS: Acid g-e reflux (pH <4.0) occurred at least once in all of the infants; prevalence was between <1% and 41% of the 12-hour record (median 4.6%, interquartile range 0.5% to 9%). The number of reflux episodes ranged from 1 to 143 (median 23). The number of apneas (>10 seconds duration) ranged from 0 to 71, median 6. There was no correlation between apnea frequency or severity and reflux frequency or duration. There was no difference in apnea frequencies between the 5 minutes after the start of a reflux episode and the 5 minutes prior to each episode.

CONCLUSION: Acid g-e reflux in the formerly preterm infant at discharge is frequent and may be prolonged; there is no association between reflux and apnea.

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References

  1. Barrington KJ, Finer N, Li D . Predischarge respiratory recordings in very low birth weight newborn infants J Pediatr 1996 129: 6 934–40

    Article  CAS  Google Scholar 

  2. Southall DP, Richards JM et al. Prolonged apnea and cardiac arrhythmias in infants discharged from neonatal intensive care units: failure to predict an increased risk for sudden infant death syndrome Pediatrics 1982 70: 844

    CAS  PubMed  Google Scholar 

  3. Cheung PY, Barrington KJ, Finer NN, Robertson CM . Early childhood neurodevelopment in very low birth weight infants with predischarge apnea Pediatr Pulmonol 1999 27: 1 14–20

    Article  CAS  Google Scholar 

  4. Marino AJ, Assing E, Carbone MT, Hiatt IM, Hegyi T, Graff M . The incidence of gastroesophageal reflux in preterm infants J Perinatol 1995 15: 5 369–71

    CAS  PubMed  Google Scholar 

  5. Frakaloss G, Burke G, Sanders M . Impact of gastroesophogeal reflux on growth and hospital stay in premature infants J Pediatr Gastroenterol Nutr 1998 26: 146–50

    Article  CAS  Google Scholar 

  6. Ferlauto JJ, Walker MW, Martin MS . Clinically significant gastroesophageal reflux in the at-risk premature neonate: relation to cognitive scores, days in the NICU, and total hospital charges J Perinatol 1998 18: 6 455–9

    CAS  PubMed  Google Scholar 

  7. Ward R, Lemons J, Molteni R . Cisapride: a survey of the frequency of use and adverse events in premature newborns Pediatrics 1999 103: 469–72

    Article  CAS  Google Scholar 

  8. de Ajuriaguerra M, Radvanyi-Bouvet MF, Huon C, Moriette G . Gastroesophageal reflux and apnea in prematurely born infants during wakefulness and sleep Am J Dis Child 1991 145: 10 1132–6

    CAS  PubMed  Google Scholar 

  9. Suys B, De Wolf D, Hauser B, Blecker U, Vandenplas Y . Bradycardia and gastroesophageal reflux in term and preterm infants: is there any relation? JPediatr Gastroenterol Nutr 1994 19: 2 187–90

    Article  CAS  Google Scholar 

  10. Orenstein S . Infantile reflux: different from adult reflux Am J Med 1997 103: 114S–9S

    Article  CAS  Google Scholar 

  11. Taminiau JA . Gastro-oesophageal reflux in children Scand J Gastroenterol Suppl 1997 223: 18–20

    CAS  PubMed  Google Scholar 

  12. Skopnik H, Silny J, Heiber O et al. Gastroesophageal reflux in infants: evaluation of a new intraluminal impedance technique J Pediatr Gastroenterol Nutr 1996 23: 5 591–8

    Article  CAS  Google Scholar 

  13. Menon AP, Schefft GL, Thach BT . Apnea associated with regurgitation in infants J Pediatr 1985 106: 4 625–9

    Article  CAS  Google Scholar 

  14. Cohen R, O'Laughlin E, Davidson G, Moore D, Lawrence D . Cisapride in the control of symptoms in infants with gastroesophageal reflux: a randomized, double-blind, placebo-controlled trial J Pediatr 1999 134: 287–92

    Article  CAS  Google Scholar 

  15. Scott RB, Ferreira C, Smith L et al. Cisapride in pediatric gastroesophageal reflux J Pediatr Gastroenterol Nutr 1997 25: 5 499–506

    Article  CAS  Google Scholar 

  16. Schulman R . Cisapride doesn't work? Don't go breakin' my heart! J Pediatr 1999 134: 262–4

    Article  Google Scholar 

  17. McClure RJ, Kristensen JH, Grauaug A . Randomised controlled trial of cisapride in preterm infants Arch Dis Child Fetal Neonatal Ed 1999 80: 3 F174–7

    Article  CAS  Google Scholar 

  18. Ng SC, Quak SH . Gastroesophageal reflux in preterm infants: norms for extended distal esophageal pH monitoring J Pediatr Gastroenterol Nutr 1998 27: 4 411–4

    Article  CAS  Google Scholar 

  19. Stark AR, Carlo WA, Tyson JE et al. Adverse effects of early dexamethasone treatment in extremely-low-birth-weight infants N Engl J Med 2001 344: 2 95–101

    Article  CAS  Google Scholar 

  20. Leach R, Robertson T, Twort C, Ward J . Hypoxic vasoconstriction in rat pulmonary and mesenteric arteries Lung Cell Mol Physiol 1994 10: L223–31

    Article  Google Scholar 

  21. Kentrup H, Baisch HJ, Kusenbach G, Heimann G, Skopnik H . Effect of cisapride on acid gastro-oesophageal reflux during treatment with caffeine Biol Neonate 2000 77: 2 92–5

    Article  CAS  Google Scholar 

  22. Tan K, Barrington KJ, Finer NN . Predischarge respiratory recordings in premature infants; influence of gestational age, postconceptional age, bpd, and intubation on apnea frequency and type Pediatr Res 1998 43: 299 (Abstract)

    Article  Google Scholar 

  23. Martin R, Fanaroff A . Neonatal apnea, bradycardia, or desaturation: does it matter? J Pediatr 1998 132: 5 1–3

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, University of California, San Diego, CA, USA

    Keith J Barrington MB ChB, MRCP(UK), FRCP(C), Ken Tan MD & Wade Rich RRT

  2. Division of Neonatology, McGill University Department of Pediatrics, Royal Victoria Hospital, Montreal, Quebec, Canada

    Keith J Barrington MB ChB, MRCP(UK), FRCP(C)

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  1. Keith J Barrington MB ChB, MRCP(UK), FRCP(C)
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  2. Ken Tan MD
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  3. Wade Rich RRT
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Barrington, K., Tan, K. & Rich, W. Apnea at Discharge and Gastro-Esophageal Reflux in the Preterm Infant. J Perinatol 22, 8–11 (2002). https://doi.org/10.1038/sj.jp.7210609

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