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Updated: Aug 1, 2026
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Apnea at discharge and gastro-esophageal reflux in the preterm infant
Keith J Barrington1, Ken Tan, Wade Rich
1Department of Pediatrics, University of California, San Diego, CA, USA.
Insights
Acid gastro-esophageal reflux is common in preterm infants at discharge, but it does not appear to be linked to apnea events. This finding is important for understanding infant respiratory patterns.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Respiratory Physiology
Background:
- Preterm infants often experience gastro-esophageal reflux (GER).
- Respiratory disturbances like apnea are also common in this population.
- Understanding the interplay between GER and respiratory patterns is crucial for infant care.
Purpose of the Study:
- To investigate the relationship between respiratory patterns and acid gastro-esophageal reflux (GER) in formerly preterm infants before hospital discharge.
- To assess the prevalence and duration of acid GER in this vulnerable group.
Main Methods:
- A cohort of 45 infants born before 32 weeks gestation was studied.
- A 12-hour multichannel recording, including esophageal pH monitoring, was performed.
- Apneas longer than 10 seconds, bradycardia, and desaturation events were documented.
Main Results:
- All infants exhibited at least one episode of acid GER.
- GER prevalence ranged from <1% to 41% (median 4.6%) over 12 hours.
- No correlation was found between the frequency or severity of apnea and GER, nor were there differences in apnea rates around reflux episodes.
Conclusions:
- Acid gastro-esophageal reflux is frequent and can be prolonged in formerly preterm infants at discharge.
- There is no observed association between acid GER and apnea in this study population.
- These findings suggest that GER may not be a primary trigger for apnea in these infants.
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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