Apnoea of prematurity

Question 1

What is apnoea?

Answer 1

Apnoea are defined as periods where breathing stops spontaneously for more than 20 seconds, or shorter periods with oxygen desaturation or bradycardia. Apnoea can occur in neonates of all gestational ages. They are often accompanied by a period of bradycardia.

Question 2

Is apnoea rare?

Answer 2

Apnoea is very common in premature neonates. They occur in almost all babies less than 28 weeks gestation and the incidence decreases with increased gestational age. In term infants apnoea usually indicate underlying pathology.

Question 3

Causes of aponoea?

Answer 3

Apnoea occur due to immaturity of the autonomic nervous system that controls respiration and heart rate. This system is more immature in premature neonates.

Apnoea are often a sign of developing illness, such as:

Infection
Anaemia
Airway obstruction (may be positional)
CNS pathology, such as seizures or haemorrhage
Gastro-oesophageal reflux
Neonatal abstinence syndrome

Question 4

Management of apnoea?

Answer 4

Neonatal units attach apnoea monitors to premature babies. These make a sound when an apnoea is occurring. Tactile stimulation is used to prompt the baby to restart breathing. Intravenous caffeine can be used to prevent apnoea and bradycardia in babies with recurrent episodes.

Episodes will settle as as the baby grows and develops