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Polygraphy after discharge in preterm infants with and without apnea in the nursery
T Hoppenbrouwers1, J E Hodgman, K Arakawa
1Department of Pediatrics, University of Southern California School of Medicine, Los Angeles.
Insights
Nine infants experienced central apnea, a pause in breathing, after their first week. Follow-up studies found no significant differences in physiological measures, but previously apneic infants had fewer awakenings at 44 weeks postconceptional age.
Area of Science:
- Neonatal Physiology
- Pediatric Sleep Medicine
- Respiratory Control in Infants
Background:
- Central apnea is a common concern in preterm infants.
- Late-onset central apnea can occur beyond the neonatal period.
- Understanding the long-term sequelae of infant apnea is crucial for developmental outcomes.
Purpose of the Study:
- To investigate the sequelae of late-onset central apnea in preterm infants.
- To compare polygraphic sleep recordings between infants with and without a history of apnea.
- To identify potential physiological differences in previously apneic infants after hospital discharge.
Main Methods:
- A cohort of preterm infants was monitored for central apnea (apnea >= 20 seconds) between 32-36 weeks postconceptional age (PCA).
- Healthy infants with and without a history of apnea underwent polygraphic recordings at 40, 44, and 52 weeks PCA.
- Measurements included sleep state, cardiorespiratory rates, skin temperature, transcutaneous oxygen (PtcO2), and carbon dioxide (PtcCO2).
Main Results:
- Polygraphic recordings did not differentiate between preterm infants with and without a history of nursery apnea.
- No significant differences were observed in sleep states, heart rate, respiratory rate, skin temperature, PtcO2, or PtcCO2 between the groups.
- The previously apneic group showed a transient decrease in awakenings at 44 weeks PCA.
Conclusions:
- Late-onset central apnea in otherwise healthy preterm infants may not be associated with persistent physiological differences detectable by standard polygraphy.
- A transient reduction in awakenings at 44 weeks PCA in previously apneic infants warrants further investigation.
- Further research is needed to understand the long-term neurodevelopmental implications of infant central apnea.
Abstract:
Nine of nineteen infants in this study exhibited two or more central apnea greater than or equal to 20 seconds when they were older than one week and between 32-36 weeks postconceptional age (PCA). We focused on the sequelae of these apneas. Apnea was separated from other morbidity associated with immaturity by the selection of consistently healthy infants. Following discharge, polygraphic tracings were obtained at 40, 44 and 52 weeks PCA in these non-apneic and previously apneic infants. Sleep states, minute by minute values for heart and respiratory rate, skin temperature and transcutaneous O2 (PtcO2) and CO2 (PtcCO2), apnea and transient decreases in PtcO2 were determined. Polygraphic measurements did not differentiate preterm infants with late apnea in the nursery from non-apneic ones. However, the apneic group exhibited a transient decrease in awakenings at 44 weeks PCA.