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Gastroesophageal reflux and apnea in prematurely born infants during wakefulness and sleep
M de Ajuriaguerra1, M F Radvanyi-Bouvet, C Huon
1Service de Médecine Néonatale, Groupe Hospitalier Cochin, Paris, France.
Insights
This study investigated if acid gastroesophageal reflux causes apnea in premature infants. Researchers found no direct link between reflux episodes and apnea occurrences in the studied infants.
Area of Science:
- Neonatal Medicine
- Pediatric Gastroenterology
- Sleep Medicine
Background:
- Apnea is a common concern in premature infants.
- Gastroesophageal reflux (GER) is a potential contributing factor to apnea persistence.
Purpose of the Study:
- To test the hypothesis that acid gastroesophageal reflux (GER) is responsible for persistent apnea in premature infants.
Main Methods:
- Twenty premature infants (median conceptional age 38.7 weeks) were monitored.
- Distal esophageal pH monitoring identified acid GER.
- Respiration recordings classified apnea (central, obstructive, mixed).
- Electroencephalography and eye movements determined sleep state (wakefulness, active sleep, quiet sleep).
Main Results:
- 134 acid GER episodes and 139 apneas (predominantly obstructive/mixed) were recorded.
- Acid GER occurred more frequently during wakefulness and active sleep than quiet sleep.
- No statistically significant relationship was found between GER and apnea events.
Conclusions:
- The study did not demonstrate a relationship between acid gastroesophageal reflux and apnea in this cohort of premature infants.
- Further research with larger sample sizes may be warranted.
Abstract:
The hypothesis that acid gastroesophageal reflux may be responsible for the persistence of apnea was tested on 20 prematurely born infants, at a median conceptional age of 38.7 weeks. Gastroesophageal reflux was identified using distal esophageal pH monitoring. Apneas of durations greater than 10 seconds were identified and classified as either central or obstructive and mixed, using recordings of respiration. Wakefulness, active sleep, and quiet sleep were identified using electroencephalography and by assessing eye movements. Of 134 episodes of acid gastroesophageal reflux in the 20 subjects, more occurred during wakefulness and during active sleep than during quiet sleep. A total of 139 apneas, predominantly of the obstructive and mixed type, occurred. No relationship could, however, be demonstrated, in this rather small number of patients, between the occurrence of gastroesophageal reflux and that of apneas.