children s health issues
Apnea of Prematurity
Introduction
Apnea (not breathing) of prematurity is a pause in breathing that lasts for 20 seconds or more in an infant born before 37 weeks of gestation who is not known to have any underlying disorder that causes apnea. Apnea episodes may occur in premature newborns if the part of their brain that controls breathing (respiratory center) has not matured fully. Apnea may lower the amount of oxygen in the blood, resulting in a slow heart rate and color changes in the lips and/or skin. This disorder is diagnosed by observation or by the alarm of a monitor attached to the newborn. If gentle prodding does not cause the newborn to resume breathing, artificial respiration may be needed. Newborns with significant apnea are givencaffeine, along with other treatments, to stimulate breathing. As the respiratory center of the brain matures, apnea episodes become less frequent and then stop altogether. (See also Overview of General Problems in Newborns .) Apnea of prematurity commonly occurs in about 25% of infants who are born Gestational Age (delivered before 37 weeks of This disorder usually begins 2 to 3 days after birth and only rarely on the first day. In apnea of prematurity, newborns may have repeated episodes of normal breathing alternating with brief pauses in breathing. In some premature babies, the pause in breathing may not last 20 seconds but does cause a decrease in the heart rate or in the amount of oxygen in the blood. Shorter pauses in breathing that cause decreases in heart rate or blood oxygen levels are still considered apnea of prematurity. There arethree types of apnea: Central Obstructive Mixed occurs when the part of the brain that controls breathing ( Control of Breathing ) is not functioning properly because it has not matured fully. This is the most common type of apnea of prematurity. Obstructive apneais caused by temporary blockage of the throat (pharynx) due to low muscle tone or a bending forward of the neck. This type may occur in full-term babies as well as those born prematurely. Mixed apneais a combination of central apnea and obstructive apnea. In all types of apnea, the heart rate can become slow and levels of oxygen can decrease. Although premature birth is a risk factor for Sudden Infant Death Syndrome (SIDS) (SIDS) as well as apnea of prematurity, apnea of prematurity itself is not known to be a risk factor for SIDS. Not all pauses in breathing are problematic. Periodic breathing is 5 to 20 seconds of normal breathing followed by periods of apnea that last less than 20 seconds. Periodic breathing is common among premature newborns and is not considered apnea of prematurity. Full-term newborns can also have periodic breathing. It does not cause the heart rate or oxygen levels to drop and usually does not cause other problems. 