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Neonatology pp 1021–1033Cite as

Apnea of Prematurity and Sudden Infant Death Syndrome

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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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Authors and Affiliations

  1. Department of Neonatology, Tübingen University Hospital, Tübingen, Germany

    Christian F. Poets

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  1. Christian F. Poets
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Correspondence to Christian F. Poets .

Editor information

Editors and Affiliations

  1. Department of Pediatrics Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

    Giuseppe Buonocore

  2. Department of Pediatrics Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

    Rodolfo Bracci

  3. Liverpool Women’s Hospital Neonatal Unit, Liverpool, UK

    Michael Weindling

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Poets, C.F. (2018). Apnea of Prematurity and Sudden Infant Death Syndrome. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-319-29489-6_213

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  • DOI: https://doi.org/10.1007/978-3-319-29489-6_213

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-29487-2

  • Online ISBN: 978-3-319-29489-6

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