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Neonatology pp 1021-1033 | Cite as

Apnea of Prematurity and Sudden Infant Death Syndrome

  • Christian F. Poets
Reference work entry

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.

List of 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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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeonatologyTübingen University HospitalTübingenGermany

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