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. 2024 Jun;113(6):1298-1305.
doi: 10.1111/apa.17166. Epub 2024 Feb 20.

Preterm infants experience a nadir in cerebral oxygenation during sleep three months after hospital discharge

Alicia K Yee  1 , Marisha Shetty  1 , Leon S Siriwardhana  1 , Lisa M Walter  1 , Flora Y Wong  1   2 , Rosemary S C Horne  1
Affiliations

Preterm infants experience a nadir in cerebral oxygenation during sleep three months after hospital discharge

Alicia K Yee et al. Acta Paediatr. 2024 Jun.

Abstract

Aim: Preterm infants are at increased risk of Sudden Infant Death Syndrome (SIDS) and frequently experience short central apnoeas which can occur in isolation or a repetitive pattern (periodic breathing). We investigated the relationship between central apnoeas experienced before and over the 6 months after hospital discharge and cerebral oxygenation.

Methods: Preterm infants born between 28 and 32 weeks gestational age (GA) were studied during supine daytime sleep at 32-36 weeks post menstrual age (PMA) (n = 40), 36-40 weeks PMA (n = 27), 3-months corrected age (CA) (n = 20) and 6-months CA (n = 26). Cerebral tissue oxygenation (TOI), peripheral oxygenation (SpO2) and heart rate were recorded continuously. The percentage total sleep time (%TST) spent having central apnoeas at each study and cerebral fractional oxygen extraction (SpO2-TOI/SpO2) were calculated.

Results: %TST spent with central apnoeas decreased with increasing age in both active sleep (AS) and quiet sleep (QS). TOI tended to be lower and cerebral fractional oxygen extraction higher at 3 months compared to the other studies and this reached statistical significance compared to 32-36 weeks in QS.

Conclusion: The nadir in cerebral tissue oxygenation at 3 months of age coincides with the peak risk period for SIDS and this may contribute to increased risk in these infants.

Keywords: apnoea; intermittent hypoxia; periodic breathing; prematurity; sleep; sudden infant death syndrome.

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