title: The longitudinal effects of persistent periodic breathing on cerebral oxygenation in preterm infants.
abstract: OBJECTIVE
  Periodic breathing is common in preterm infants, but is thought to be benign. The aim of our study was to assess the incidence and impact of periodic breathing on heart rate (HR), oxygen saturation (SpO2), and brain tissue oxygenation index (TOI) over the first six months after term-equivalent age.
  
  
  METHODS
  Twenty-four preterm infants (27-36 weeks gestational age) were studied with daytime polysomnography in quiet sleep (QS) and active sleep (AS) and in both the prone and supine positions at 2-4 weeks, 2-3 months, and 5-6 months post-term corrected age. HR, SpO2, and TOI (NIRO-200 spectrophotometer) were recorded. Periodic breathing episodes were defined as greater than or equal to three sequential apneas each lasting ≥3 s.
  
  
  RESULTS
  A total 164 individual episodes of periodic breathing were recorded in 19 infants at 2-4 weeks, 62 in 12 infants at 2-3 months, and 35 in 10 infants at 5-6 months. There was no effect of gestational age on periodic breathing frequency or duration. Falls in HR (-21.9 ± 2.7%) and TOI (-13.1 ± 1.5%) were significantly greater at 2-3 months of age compared to 2-4 weeks of age.
  
  
  CONCLUSIONS
  The majority of preterm infants discharged home without clinical respiratory problems had persistent periodic breathing. Although in most infants periodic breathing was not associated with significant falls in SpO2 or TOI, several infants had significant desaturations and reduced cerebral oxygenation especially during AS. The clinical significance of this on neurodevelopmental outcome is unknown and warrants further investigations.
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute, Monash University, Melbourne, VIC, Australia; Laboratoire PériTox, UMR-I 01 INERIS, Faculté de Médecine, Université de Picardie Jules Verne, Amiens, France.
authors.forename: Pauline F F
authors.initials: PF
authors.lastname: Decima
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute, Monash University, Melbourne, VIC, Australia; Department of Paediatrics, Monash University, Melbourne, VIC, Australia.
authors.forename: Karinna L
authors.initials: KL
authors.lastname: Fyfe
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute, Monash University, Melbourne, VIC, Australia.
authors.forename: Alexsandria
authors.initials: A
authors.lastname: Odoi
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute, Monash University, Melbourne, VIC, Australia; Department of Paediatrics, Monash University, Melbourne, VIC, Australia.
authors.forename: Flora Y
authors.initials: FY
authors.lastname: Wong
authors.affiliation: The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute, Monash University, Melbourne, VIC, Australia; Department of Paediatrics, Monash University, Melbourne, VIC, Australia. Electronic address: rosemary.horne@monash.edu.
authors.forename: Rosemary S C
authors.initials: RS
authors.lastname: Horne
mesh_terms: D001921:Brain / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D002534:Hypoxia, Brain / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D017286:Polysomnography; D020182:Sleep Apnea, Central / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology
chemical_list: D010100:Oxygen
keywords: Arterial oxygen saturation; Heart rate; Neonate; Pediatric; Sleep