Abstract
Apnea of prematurity is a self-resolving, yet very common condition in preterm infants. Recent observational data suggest that the intermittent hypoxemia often occurring with it may be associated with an increased risk of adverse outcome, including cerebral palsy, retinopathy of prematurity, and death. Treatment should follow an incremental approach, starting with head elevated positioning, followed by caffeine administration and nasal respiratory support.
Sudden infant death syndrome has decreased markedly in incidence following primary prevention campaigns in many countries, yet continues to be a leading cause of death beyond the neonatal period. Although still incompletely understood, it seems that death is the result of an external trigger (e.g., prone sleep position) occurring in a vulnerable infant (e.g., born to a mother who smoked during pregnancy) during a critical developmental period (e.g., 2–4 months of age). Memory monitor recordings obtained during SIDS suggest that bradycardia, probably resulting from severe hypoxemia, is the primary abnormality in the sequence of events ultimately resulting in these deaths. Prevention should focus on a safe sleep environment, i.e., supine sleep position, a smoke-free environment, avoidance of overheating, use of a sleeping bag, and room but not bed sharing.
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Abbreviations
- AAP:
-
American Academy of Pediatrics
- ALTE:
-
Apparent life-threatening event
- AOP:
-
Apnea of prematurity
- BPD:
-
Bronchopulmonary dysplasia
- CDC:
-
Centers for Disease Control
- CI:
-
Confidence interval
- CO2 :
-
Carbon dioxide
- IH:
-
Intermittent hypoxemia
- LQTS:
-
Long-QT-syndrome
- MCAD:
-
Medium-chain acyl-CoA dehydrogenase
- N-CPAP:
-
Nasal continuous positive airway pressure
- N-IPPV:
-
Nasal intermittent positive pressure ventilation
- NNT:
-
Number needed to treat
- OR:
-
Odds ratio
- PaO2 :
-
Partial pressure of oxygen in arterial blood
- PAR:
-
Population-attributable risk
- RCT:
-
Randomized controlled trial
- ROP:
-
Retinopathy of prematurity
- RR:
-
Relative risk
- SIDS:
-
Sudden infant death syndrome
- SpO2 :
-
Arterial oxygen saturation measured by pulse oximetry
- TPN:
-
Total parenteral nutrition
- VLBW:
-
Very low birth weight
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Poets, C.F. (2016). Apnea of Prematurity and Sudden Infant Death Syndrome. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-319-18159-2_213-1
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DOI: https://doi.org/10.1007/978-3-319-18159-2_213-1
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Apnea of Prematurity and Sudden Infant Death Syndrome- Published:
- 09 February 2017
DOI: https://doi.org/10.1007/978-3-319-18159-2_213-2
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Apnea of Prematurity and Sudden Infant Death Syndrome- Published:
- 30 December 2016
DOI: https://doi.org/10.1007/978-3-319-18159-2_213-1