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Association between Apnea of Prematurity and Respiratory Distress Syndrome in Late Preterm Infants: An Observational Study

View Article: PubMed Central - PubMed

ABSTRACT

Background: Late preterm infants (34–36 weeks’ gestation) remain a population at risk for apnea of prematurity (AOP). As infants affected by respiratory distress syndrome (RDS) have immature lungs, they might also have immature control of breathing. Our hypothesis is that an association exists between RDS and AOP in late preterm infants.

Objective: The primary objective of this study was to assess the association between RDS and AOP in late preterm infants. The secondary objective was to evaluate if an association exists between apparent RDS severity and AOP.

Methods: This retrospective observational study was realized in a tertiary care center between January 2009 and December 2011. Data from late preterm infants who presented an uncomplicated perinatal evolution, excepted for RDS, were reviewed. Information related to AOP and RDS was collected using the medical record. Odds ratios were calculated using a binary logistic regression adjusted for gestational age and sex.

Results: Among the 982 included infants, 85 (8.7%) had an RDS diagnosis, 281 (28.6%) had AOP diagnosis, and 107 (10.9%) were treated with caffeine for AOP. There was a significant association between AOP treated with caffeine and RDS for all infants (OR = 3.3, 95% CI: 2.0–5.7). There was no association between AOP and RDS in 34 weeks infants [AOR: 1.6 (95% CI: 0.7–3.8)], but an association remains for 35 [AOR: 5.7 (95% CI: 2.5–13.4)] and 36 [OR = 7.8 (95% CI: 3.2–19.4)] weeks infants. No association was found between apparent RDS severity and AOP, regarding mean oxygen administration duration or complications associated with RDS.

Conclusion: The association between RDS and AOP in late preterm infants reflects that patients affected by RDS are not only presenting lung immaturity but also respiratory control immaturity. Special consideration should be given before discontinuing monitoring after RDS resolution in those patients.

No MeSH data available.


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Figure 1: Exclusion criteria.

Mentions: This is a tertiary care center, retrospective cohort study of the population of late preterm infants admitted between January 2009 and December 2011. Participants were identified through medical records review. The studied population included late preterm infants born or admitted to the Mother and Child Center of the CHU de Québec and who presented an uncomplicated perinatal evolution, except for RDS. We included only patients susceptible to be discharged soon after birth or after RDS resolution. The list of every diagnosis from the medical records was reviewed for each patient by the main author. Those who presented any medical or surgical condition that could significantly prolong the need for cardiorespiratory monitoring were excluded according to pre-specified criteria (Figure 1). The included patients were hospitalized either in the neonatal intensive care unit (NICU), in the newborn nursery, or in the moms’ room. Frequent reasons for NICU admission at birth included respiratory distress and birth weight under 2.3 kg as per our protocol. All the patients admitted to the NICU received systematic cardiorespiratory monitoring. Those requiring intravenous infusion were hospitalized in the newborn nursery. This study was approved by the hospital ethics committee. Since this is a retrospective study and that all information collected were anonymous, no consent was required.


Association between Apnea of Prematurity and Respiratory Distress Syndrome in Late Preterm Infants: An Observational Study
Exclusion criteria.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036403&req=5

Figure 1: Exclusion criteria.
Mentions: This is a tertiary care center, retrospective cohort study of the population of late preterm infants admitted between January 2009 and December 2011. Participants were identified through medical records review. The studied population included late preterm infants born or admitted to the Mother and Child Center of the CHU de Québec and who presented an uncomplicated perinatal evolution, except for RDS. We included only patients susceptible to be discharged soon after birth or after RDS resolution. The list of every diagnosis from the medical records was reviewed for each patient by the main author. Those who presented any medical or surgical condition that could significantly prolong the need for cardiorespiratory monitoring were excluded according to pre-specified criteria (Figure 1). The included patients were hospitalized either in the neonatal intensive care unit (NICU), in the newborn nursery, or in the moms’ room. Frequent reasons for NICU admission at birth included respiratory distress and birth weight under 2.3 kg as per our protocol. All the patients admitted to the NICU received systematic cardiorespiratory monitoring. Those requiring intravenous infusion were hospitalized in the newborn nursery. This study was approved by the hospital ethics committee. Since this is a retrospective study and that all information collected were anonymous, no consent was required.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Late preterm infants (34–36 weeks’ gestation) remain a population at risk for apnea of prematurity (AOP). As infants affected by respiratory distress syndrome (RDS) have immature lungs, they might also have immature control of breathing. Our hypothesis is that an association exists between RDS and AOP in late preterm infants.

Objective: The primary objective of this study was to assess the association between RDS and AOP in late preterm infants. The secondary objective was to evaluate if an association exists between apparent RDS severity and AOP.

Methods: This retrospective observational study was realized in a tertiary care center between January 2009 and December 2011. Data from late preterm infants who presented an uncomplicated perinatal evolution, excepted for RDS, were reviewed. Information related to AOP and RDS was collected using the medical record. Odds ratios were calculated using a binary logistic regression adjusted for gestational age and sex.

Results: Among the 982 included infants, 85 (8.7%) had an RDS diagnosis, 281 (28.6%) had AOP diagnosis, and 107 (10.9%) were treated with caffeine for AOP. There was a significant association between AOP treated with caffeine and RDS for all infants (OR = 3.3, 95% CI: 2.0–5.7). There was no association between AOP and RDS in 34 weeks infants [AOR: 1.6 (95% CI: 0.7–3.8)], but an association remains for 35 [AOR: 5.7 (95% CI: 2.5–13.4)] and 36 [OR = 7.8 (95% CI: 3.2–19.4)] weeks infants. No association was found between apparent RDS severity and AOP, regarding mean oxygen administration duration or complications associated with RDS.

Conclusion: The association between RDS and AOP in late preterm infants reflects that patients affected by RDS are not only presenting lung immaturity but also respiratory control immaturity. Special consideration should be given before discontinuing monitoring after RDS resolution in those patients.

No MeSH data available.