Pathogenesis, clinical presentation, and diagnosis of apnea of prematurity
- Richard Martin, MD
Richard Martin, MD
- Section Editor — Neonatology
- Professor, Pediatrics, Reproductive Biology, and Physiology & Biophysics
- Case Western Reserve University School of Medicine
- Section Editors
- Joseph A Garcia-Prats, MD
Joseph A Garcia-Prats, MD
- Section Editor — Neonatology
- Professor of Pediatrics
- Baylor College of Medicine
- George B Mallory, MD
George B Mallory, MD
- Section Editor — Pediatric Pulmonology
- Associate Professor of Pediatrics
- Baylor College of Medicine
Apnea of prematurity is a developmental disorder in preterm infants that is a consequence of immature respiratory control. Apnea of prematurity is most widely defined as cessation of breathing for more than 20 seconds, or a shorter respiratory pause associated with oxygen desaturation and/or bradycardia in infants who are younger than 37 weeks gestation . The frequency of symptoms is inversely proportional to gestational age (GA), and almost all infants with a GA less than 28 weeks are affected.
The pathogenesis, diagnosis, and clinical presentation of apnea of prematurity are reviewed here. The management of apnea of prematurity is discussed separately. (See "Management of apnea of prematurity".)
Apnea — Apnea is defined as the cessation of respiratory airflow. Short breathing pauses (5 to 10 seconds) occur frequently in preterm infants and are normal.
Apnea of prematurity is most widely defined as cessation of breathing for more than 20 seconds or a shorter respiratory pause associated with oxygen desaturation and/or bradycardia in infants who are younger than 37 weeks gestation . Apnea of infancy refers to infants with a gestational age (GA) of 37 weeks or greater at the onset of apnea.
Apnea is classified as central, obstructive, or mixed depending on the presence of continued inspiratory efforts and upper airway obstruction.
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- Periodic breathing
- Respiratory drive
- Upper airway patency
- - Hypopharynx
- - Upper airway reflexes
- - Nasal obstruction
- - Larynx and trachea
- CLINICAL PRESENTATION
- Heart rate
- Pulse oximetry
- DIFFERENTIAL DIAGNOSIS
- EVALUATION TO DETERMINE CAUSE OF APNEA
- SUMMARY AND RECOMMENDATIONS