Effective method for screening for respiratory inhibition after crying in infants.
BACKGROUND
In order to establish an effective screening method for respiratory inhibition after crying (RIAC), we prospectively studied the correlations between infant RIAC and perinatal factors.


METHODS
We monitored infants (n=141) born from May through July 2009 with polygraphy and evaluated the presence of RIAC and respiratory pause that occurred when feeding was initiated immediately after crying with a decrease in oxygen saturation (SpO(2) ) to <60%. The infants were screened for increased echogenicity, a cyst in the ganglionic eminence (GE), or a subependymal cyst by cranial ultrasound. Furthermore, we evaluated the correlations between RIAC and perinatal factors.


RESULTS
Eleven infants displayed RIAC and 31 experienced respiratory pause during feeding with a decrease in SpO(2) to <60%. There were no significant correlations between RIAC and perinatal factors. Forty infants had ultrasound abnormalities (increased echogenicity in the GE, 26; cyst in the GE, nine; and subependymal cyst, seven). Sensitivity, specificity, and efficiency of abnormal cranial ultrasound findings for RIAC were 1.00, 0.777, and 0.794, respectively. The odds ratio, sensitivity, specificity, and efficiency of the combination of abnormal cranial ultrasound findings and respiratory pause during feeding with a decrease in SpO(2) to <60% and RIAC were 35.9 (P<0.001), 0.727, 0.931, and 0.915, respectively.


CONCLUSIONS
The combination of abnormal cranial ultrasound findings and respiratory pause during feeding with a decrease in SpO(2) appears to be an effective method of screening for RIAC.
Minowa
Hideki
H
Department of Neonatal Intensive Care Unit, Nara Prefectural Hospital, Nara Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan. nicuminowa@yahoo.co.jp
Hirayama
Koichiro
K
Bando
Yuka
Y
Yasuhara
Hajime
H
Ohgitani
Ayako
A
D001049:Apnea / Q000175:diagnosis* / Q000503:physiopathology; D003448:Crying / Q000502:physiology*; D004453:Echoencephalography; D005260:Female; D045888:Ganglion Cysts / Q000000981:diagnostic imaging; D006801:Humans; D016017:Odds Ratio; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D010100:Oxygen