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Respiratory inhibition after crying in infants

Hideki Minowa1, Satomi Kubo, Hiroyuki Yoshizawa

  • 1Division of Pediatrics, Nara Hospital, Kinki University School of Medicine, Ikoma, Nara, Japan. nicu@m3.kcn.ne.jp

Pediatrics International : Official Journal of the Japan Pediatric Society
|December 16, 2006
PubMed

Insights

Cranial ultrasonography can identify full-term neonates at risk for respiratory inhibition after crying, a condition marked by decreased SpO2. Theophylline effectively treated these episodes, suggesting a potential preventative screening method.

Area of Science:

  • Neonatal Medicine
  • Pediatric Neurology

Background:

  • Full-term neonates can experience respiratory inhibition post-crying, characterized by significant SpO2 decrease.
  • Associated cranial findings include increased echogenicity or cysts in the ganglionic eminence or subependymal region.

Purpose of the Study:

  • To prospectively examine the link between post-crying respiratory inhibition and specific cranial ultrasound findings.
  • To investigate potential prevention and treatment strategies for this neonatal episode.

Main Methods:

  • Cranial ultrasonography screened 381 full-term neonates.
  • Polygraphy was performed on neonates with identified cranial abnormalities (n=104) and a control group (n=50).
  • Respiratory inhibition was defined as central apnea post-crying with SpO2 <60%.

Main Results:

  • 104 of 381 neonates had cranial abnormalities; 60 experienced respiratory inhibition.
  • Oxygen therapy was ineffective for 17 neonates with severe inhibition.
  • Theophylline successfully treated episodes, normalizing SpO2, and was discontinued by 6 months.

Conclusions:

  • Respiratory inhibition with SpO2 decrease after crying occurs in term neonates without other birth abnormalities.
  • Cranial ultrasonography is a viable screening tool for identifying at-risk neonates.
Abstract

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