Apnea of prematurity
| Apnea of prematurity | |
|---|---|
| Synonyms | AOP |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Cessation of breathing for more than 20 seconds, bradycardia, cyanosis |
| Complications | N/A |
| Onset | Premature birth |
| Duration | Usually resolves by 36 to 37 weeks gestational age |
| Types | N/A |
| Causes | Immature central nervous system |
| Risks | Prematurity, low birth weight |
| Diagnosis | Clinical diagnosis, observation |
| Differential diagnosis | Sepsis, neurological disorders, gastroesophageal reflux disease |
| Prevention | N/A |
| Treatment | Caffeine citrate, nasal continuous positive airway pressure (NCPAP) |
| Medication | N/A |
| Prognosis | Generally good, resolves with maturation |
| Frequency | Common in infants born before 34 weeks gestation |
| Deaths | N/A |
Apnea of Prematurity
Apnea of prematurity (AOP) is a condition that affects premature infants, typically those born before 28 weeks of gestation. It is characterized by periods of stopped breathing for more than 20 seconds, or shorter periods if associated with a slow heart rate (bradycardia) or low oxygen levels (hypoxia).
Etiology
The exact cause of AOP is not fully understood, but it is believed to be due to the immaturity of the baby's respiratory control center in the brainstem. Other factors that may contribute include anemia, infection, metabolic disorders, and disturbances in the baby's sleep-wake cycle.
Symptoms
The primary symptom of AOP is pauses in breathing (apnea). These episodes may be accompanied by a slow heart rate (bradycardia) and/or a change in color (cyanosis) due to low oxygen levels in the blood. Other symptoms may include poor feeding, low body temperature (hypothermia), and a weak or high-pitched cry.
Diagnosis
AOP is typically diagnosed in the neonatal intensive care unit (NICU) where the baby's breathing and heart rate can be continuously monitored. The diagnosis is based on the baby's gestational age, symptoms, and the exclusion of other causes of apnea.
Treatment
The primary goal of treatment is to support the baby's breathing and maintain adequate oxygen levels. This may involve the use of supplemental oxygen, medications, and in some cases, mechanical ventilation. The baby's feeding and growth are also closely monitored, as poor growth can exacerbate the condition.
Prognosis
Most infants with AOP improve with time as their respiratory control center matures. By the time they reach their expected due date, most infants no longer have episodes of apnea.
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Contributors: Prab R. Tumpati, MD