Predischarge respiratory recordings in very low birth weight newborn infants

Abstract

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

Objective: 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.

Methods: 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.

Results: 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.

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