title: Clinical associations of immature breathing in preterm infants: part 1-central apnea.
abstract: Apnea of prematurity (AOP) is nearly universal among very preterm infants, but neither the apnea burden nor its clinical associations have been systematically studied in a large consecutive cohort.
  
  
  
  We analyzed continuous bedside monitor chest impedance and electrocardiographic waveforms and oxygen saturation data collected on all neonatal intensive care unit (NICU) patients <35 wk gestation from 2009 to 2014 (n = 1,211; >50 infant-years of data). Apneas, with bradycardia and desaturation (ABDs), defined as central apnea ≥10 s associated with both bradycardia <100 bpm and oxygen desaturation <80%, were identified using a validated automated algorithm.
  
  
  
  Number and duration of apnea events decreased with increasing gestational age (GA) and postmenstrual age (PMA). ABDs were more frequent in infants <31 wk GA at birth but were not more frequent in those with severe retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), or severe intraventricular hemorrhage (IVH) after accounting for GA. In the day before diagnosis of late-onset septicemia and necrotizing enterocolitis, ABD events were increased in some infants. Many infants continued to experience short ABD events in the week prior to discharge home.
  
  
  
  Frequency of apnea events is a function of GA and PMA in infants born preterm, and increased apnea is associated with acute but not with chronic pathologic conditions.
authors.affiliation: Department of Pediatrics, The University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Karen
authors.initials: K
authors.lastname: Fairchild
authors.affiliation: Department of Physics, The College of William and Mary, Williamsburg, Virginia.
authors.forename: Mary
authors.initials: M
authors.lastname: Mohr
authors.affiliation: Department of Pediatrics, The University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Alix
authors.initials: A
authors.lastname: Paget-Brown
authors.affiliation: Department of Pediatrics, The University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Christa
authors.initials: C
authors.lastname: Tabacaru
authors.affiliation: Department of Medicine, The University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Douglas
authors.initials: D
authors.lastname: Lake
authors.affiliation: Department of Physics, The College of William and Mary, Williamsburg, Virginia.
authors.forename: John
authors.initials: J
authors.lastname: Delos
authors.affiliation: Department of Medicine, The University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Joseph Randall
authors.initials: JR
authors.lastname: Moorman
authors.affiliation: Department of Pediatrics, The University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: John
authors.initials: J
authors.lastname: Kattwinkel
mesh_terms: D000465:Algorithms; D001049:Apnea / Q000150:complications* / Q000503:physiopathology; D002110:Caffeine / Q000627:therapeutic use; D015331:Cohort Studies; D004562:Electrocardiography; D020345:Enterocolitis, Necrotizing / Q000150:complications; D005260:Female; D005865:Gestational Age; D006470:Hemorrhage / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D015931:Intensive Care, Neonatal; D008297:Male; D010100:Oxygen; D010351:Patient Discharge; D011247:Pregnancy; D012119:Respiration; D012120:Respiration Disorders / Q000150:complications* / Q000503:physiopathology; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications; D020182:Sleep Apnea, Central / Q000150:complications* / Q000503:physiopathology
chemical_list: D002110:Caffeine; D010100:Oxygen