Infant apnea and gastroesophageal reflux: a critical review and framework for further investigation

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Updated: Jul 14, 2026

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
06:46

Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring

Published on: December 14, 2020

Christopher Slocum1, Anna Maria Hibbs, Richard J Martin

  • 1Division of Neonatology, Rainbow Babies and Children's Hospital, Suite 3100, Cleveland, OH 44106, USA.

Current Gastroenterology Reports
|May 22, 2007
PubMed

Insights

Gastroesophageal reflux and apnea of prematurity are common in infants. While a link is debated, most reflux doesn't cause apnea, though some cases may be related.

Area of Science:

  • Neonatology
  • Pediatric Gastroenterology
  • Respiratory Physiology

Background:

  • Gastroesophageal reflux (GER) and apnea of prematurity (AOP) are prevalent in premature infants.
  • A definitive causal link between GER and AOP remains controversial.
  • Physiologic mechanisms suggest protective reflexes could connect GER to apnea.

Purpose of the Study:

  • To review evidence supporting and refuting a causal relationship between GER and AOP.
  • To discuss current evaluation techniques for GER and AOP.
  • To identify areas for future research on this association.

Main Methods:

  • Literature review of clinical studies and physiologic evidence.
  • Analysis of studies investigating GER-AOP association in premature infants.
  • Discussion of diagnostic methods for GER and AOP.

Main Results:

  • Most GER episodes are not associated with apnea.
  • A potential causal link may exist in a subset of infants or specific reflux events.
  • Evidence for or against a causal relationship is conflicting.

Conclusions:

  • The relationship between GER and AOP is complex and not fully understood.
  • Further research is needed to clarify the role of reflux character and infant predisposition.
  • Distinguishing unrelated GER from potentially causative events is crucial.

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