Neonatal apnea research: a bibliometric analysis of trends, clusters, and paradigm shifts

The clinical paradigm for neonatal apnea has shifted profoundly, from managing acute cardiorespiratory events to preventing adverse long-term neurodevelopmental outcomes. This evolution has generated a vast and complex body of research, yet a systematic map of its historical trajectory, intellectual structure, and emerging frontiers is currently lacking. This study provides the first comprehensive bibliometric analysis of the global research landscape of neonatal apnea.

Publications from the Web of Science Core Collection up to December 31, 2025 were retrieved, with 2,517 articles included for analysis. Co-authorship, citation, and keyword co-occurrence analyses were performed using VOSviewer and Bibliometrix to identify influential contributors, foundational research, and thematic evolution.

Research output showed sustained exponential growth (R²=0.8591), led by collaborative hubs in the United States and Australia. The field's intellectual foundation rests on landmark trials of caffeine and non-invasive ventilation, and pivotal studies link intermittent hypoxemia to long-term disability. Thematic analysis revealed five distinct clusters, with a clear temporal evolution from foundational topics (e.g., periodic breathing) toward modern frontiers. Notably, neurodevelopment, machine learning, and the mechanisms of intermittent hypoxia have emerged as the dominant, high-impact research hotspots.

This study charts the 46-year evolution of neonatal apnea research, quantitatively mapping its paradigm shift from a focus on acute respiratory control to a deep interrogation of its long-term neurodevelopmental consequences. Our findings provide a data-driven framework that identifies foundational pillars, core research areas, and critical emerging frontiers, offering a valuable compass for future investigation in this vital field.