Apnea is a pause in breathing for 20 seconds or more. Premature
infants younger than 32 to 34 weeks'
gestational age commonly have apneic spells, usually
while sleeping. During an apneic spell, an infant's blood oxygen level can drop
(oxygen desaturation, or "desat"), which is sometimes followed by a drop in
heart rate (bradycardia).
The cause of apnea of prematurity is poorly understood. It is known
to be related to the infant's immature neurological, muscular, and respiratory
Until about 34 weeks' gestation, premature infants are electronically
monitored for apnea and bradycardia spells, as well as for desaturation. Apnea
spells generally stop around the time an infant is able to have all feedings by
nipple, rather than tube. This is usually between 34 and 38 weeks, though it
can take longer. Preemies born extremely early, between 24 and 28 weeks, are
more likely to have apnea beyond their due dates. A few have apnea for several
months. After apnea spells have stopped for a week or more, they usually do not
Severe apnea is usually treated with medicine, breathing support,
or both. Common treatments include:
Hansen TN, Corbet A (2005). Control of breathing. In
HW Taeusch et al., eds., Avery's Diseases of the Newborn, 8th ed., pp. 616–633. Philadelphia: Elsevier
April 14, 2011
Sarah Marshall, MD - Family Medicine
& John Pope, MD - Pediatrics
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