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Apnoea in the newborn infant.

D J Henderson-Smart, G Cohen

    Australian Paediatric Journal
    |January 1, 1986
    PubMed
    Summary

    Apnoea in infants, especially preterm infants, is often linked to brain-stem and upper airway immaturity. This can increase the risk of breathing pauses and potentially Sudden Infant Death Syndrome (SIDS).

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    Area of Science:

    • Neonatal Medicine
    • Pediatric Neurology
    • Respiratory Physiology

    Background:

    • Clinical apnoea in infants is defined as a breathing pause >20s or shorter with bradycardia.
    • Apnoea is rare in term infants but common in preterm infants, increasing with lower gestational age.
    • Immaturity, particularly of the brain-stem, is a primary factor, exacerbated by insults like infection or hypoxia.

    Purpose of the Study:

    • To explore the relationship between immaturity and clinical apnoea in infants.
    • To investigate the role of brain-stem and upper airway control in apnoea.
    • To assess potential links between apnoea, immaturity, and Sudden Infant Death Syndrome (SIDS).

    Main Methods:

    • Auditory evoked response studies to assess brain-stem maturity.
    • Histopathological examination of infants deceased from SIDS.
    • Observation of upper airway patency during nasal occlusion in preterm infants.

    Main Results:

    • Immature brain-stem responses correlate with a higher incidence of infant apnoea.
    • Brain-stem immaturity is implicated in SIDS pathophysiology.
    • Preterm infants with prolonged intubation and neurological abnormalities show disordered upper airway control and instability.

    Conclusions:

    • Infant apnoea is strongly associated with neurological and respiratory immaturity.
    • Disordered control of upper airway patency may contribute to obstructive apnoea patterns.
    • Preterm infants with chronic pulmonary issues and prolonged intubation face elevated risks for sudden unexpected death.

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