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Pseudoreflux syndrome-increased periodic breathing during the neonatal period presenting as feeding-related

A R Spitzer1, M Newbold, N Alicea-Alvarez

  • 1Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA 19107.

Clinical Pediatrics
|September 1, 1991
PubMed

Insights

Infants presenting with apparent life-threatening events may have pseudoreflex, a condition distinct from gastroesophageal reflux-associated apnea. Careful evaluation of respiratory patterns is crucial for accurate diagnosis in neonates.

Area of Science:

  • Neonatal medicine
  • Pediatric pulmonology
  • Gastroenterology

Background:

  • Gastroesophageal reflux (GER) is often associated with apnea in infants.
  • Apparent life-threatening events (ALTEs) in neonates require thorough investigation.
  • Previous studies linked GER to obstructive apnea, but a distinct pattern emerged in this cohort.

Purpose of the Study:

  • To evaluate neonates presenting with symptoms suggestive of GER-associated apnea.
  • To differentiate between GER-associated apnea and a similar presenting condition.
  • To characterize the respiratory patterns in infants with pseudoreflux.

Main Methods:

  • Evaluation of 16 neonates at a specialized Breathing Disorder Center.
  • Assessment of clinical history, including emesis and ALTEs.
  • Analysis of respiratory patterns during sleep, focusing on periodic breathing and obstructive apnea.

Main Results:

  • Infants exhibited increased periodic breathing (12.1 ± 1.8% of sleep time) rather than obstructive apnea.
  • Pathologic gastroesophageal reflux was not consistently diagnosed in relation to apneic events.
  • The condition was termed pseudoreflux due to similarities with GER-associated apnea.

Conclusions:

  • Pseudoreflux is a distinct disorder in neonates presenting with ALTEs and symptoms mimicking GER-associated apnea.
  • Increased periodic breathing, not obstructive apnea, characterizes pseudoreflux.
  • Early and accurate diagnosis through careful reflux and respiratory pattern evaluation is essential for affected infants.

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