The Longitudinal Effects of Persistent Apnea on Cerebral Oxygenation in Infants Born Preterm

Rosemary S. C. Horne, Annie C. H. Fung, Scott McNeil, Karinna L. Fyfe, Alexsandria Odoi, Flora Y. Wong

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29 Citations (Scopus)


Objective To assess the incidence and impact of persistent apnea on heart rate (HR), oxygen saturation (SpO2), and brain tissue oxygenation index (TOI) over the first 6 months after term equivalent age in ex-preterm infants. Study design Twenty-four preterm infants born between 27 and 36 weeks of gestational age were studied with daytime polysomnography at 2-4 weeks, 2-3 months, and 5-6 months post-term corrected age. Apneas lasting ≥3 seconds were included and maximal percentage changes (nadir) in HR, SpO2 and tissue oxygenation index (TOI, NIRO-200 Hamamatsu) from baseline were analyzed. Results A total of 253 apneas were recorded at 2-4 weeks, 203 at 2-3 months, and 148 at 5-6 months. There was no effect of gestational age at birth, sleep state, or sleep position on apnea duration, nadir HR, SpO2, or TOI. At 2-4 weeks, the nadirs in HR (−11.1 ± 1.2 bpm) and TOI (−4.4 ± 1.0%) were significantly less than at 2-3 months (HR: −13.5 ± 1.2 bpm, P < .05; TOI: −7.5 ± 1.1 %, P < .05) and at 5-6 months (HR: −13.2 ± 1.3 bpm, P < .01; TOI: −9.3 ± 1.2%, P < .01). Conclusions In ex-preterm infants, apneas were frequent and associated with decreases in heart rate and cerebral oxygenation, which were more marked at 2-3 months and 5-6 months than at 2-4 weeks. Although events were short, they may contribute to the adverse neurocognitive outcomes that are common in ex-preterm children.

Original languageEnglish
Pages (from-to)79-84
Number of pages6
JournalThe Journal of Pediatrics
Publication statusPublished - 1 Mar 2017


  • apnea
  • preterm
  • sleep
  • sleeping position

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