title: Apnea, bradycardia and desaturation in preterm infants before and after feeding.
abstract: OBJECTIVE
  A common clinical impression is that both gastroesophageal reflux (GER) and cardiorespiratory events increase after feeding in preterm infants. We aimed to measure objectively the effects of feeding on GER, apnea, bradycardia and desaturations.
  
  
  METHODS
  We conducted a retrospective review of premature infants with a gestational age of 23 to 37 weeks at birth and a post-conceptional age of 34 to 48 weeks, who were referred for multichannel intraluminal impedance (MII), pH probe and 12-h apnea evaluation. Cardiorespiratory and GER event rates during pre- and post-feeding intervals were compared.
  
  
  RESULTS
  Thirty-six infants met the inclusion criteria. More GER events occurred after a feed than before (P=0.012). After feeds, reflux was less acidic and higher in the esophagus (P<0.05). In contrast, the rates of apnea, bradycardia and desaturations were not altered by infant feeding. Apnea of >5 s occurred at a median frequency of 0 (range 0 to 3) events per hour before a feed and 0 (0 to 2) events per hour after a feed (P=0.61).
  
  
  CONCLUSIONS
  The frequency, height and pH of GER are significantly altered by feedings in preterm infants. However, the common clinical impression that apnea, bradycardia and desaturations are more prevalent after feeding is not supported.
authors.affiliation: Carillion Roanoke Community Hospital, Roanoke, VA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Slocum
authors.forename: M
authors.initials: M
authors.lastname: Arko
authors.forename: J
authors.initials: J
authors.lastname: Di Fiore
authors.forename: R J
authors.initials: RJ
authors.lastname: Martin
authors.forename: A M
authors.initials: AM
authors.lastname: Hibbs
mesh_terms: D001049:Apnea / Q000209:etiology*; D001784:Blood Gas Analysis; D001919:Bradycardia / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology*; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000209:etiology*; D008297:Male; D010991:Plethysmography; D019518:Postprandial Period / Q000502:physiology; D012189:Retrospective Studies