Predischarge respiratory recordings in very low birth weight newborn infants

There may be a relationship between undiagnosed, ongoing apnea occurring at discharge in infants of very low birth weight and sudden infant death syndrome.

To describe patterns of apnea in former very low birth weight (< 1251 gm) infants thought to be ready for hospital discharge, and to determine the relationship between apnea at discharge and later adverse events-in particular, apparent life-threatening events (ALTEs) and sudden infant death syndrome.

One hundred eighty-seven infants had 24-hour (four-channel) recordings scored for apnea (> 12 seconds in duration) frequency, type, and duration. Infants were followed by telephone interview at 2, 4, and 6 months after discharge from the hospital.

Ninety-one percent of recordings displayed significant apnea, the majority of episodes of apnea were obstructive, and about half occurred during feedings. Infants had as many as 43 episodes in a 24-hour period, with a maximum duration of 62 seconds. There was no relationship between severity of pre-discharge episodes of apnea and ALTEs. No infants died during follow-up.

Predischarge multichannel recordings may identify infants with apnea that is not otherwise clinically apparent but do not predict the risk of an ALTE.