A study on neonatal apnea in relation to etiopathogenesis and their outcome in a rural based Medical College Hospital;West Bengal; India

Abstract

Introduction: Neonatal apnea is one of the most common causes of Sick Newborn Care Unit and Neonatal Intensive Care Unit admission. Commonest etiologies of neonatal apnea include sepsis, apnea of prematurity, central nervous system insult, Respiratory distress Syndrome. Background: Apnea in neonates may be manifestation of many serious underlying diseases as well as may be due to prematurity. Apnea of prematurity is essentially a diagnosis of exclusion carries the most excellent prognosis. Other secondary causes bear uniformly poor prognosis and essentially high mortality. Objectives: This study was conducted in a tertiary care centre to determine the different causes of apnea and to observe the outcome in relation to different birth weight, gestational age and different etiologies. Results: Out of 110 apneic neonates recruited 60% had ≥ 3 episodes of apnea while 40% had 1-2 episodes. Sepsis and apnea of prematurity were found to be the two most common causes. Average birth weight and gestational age for the sepsis group was 1598•62 gm and 32•4 wks respectively whereas average birth weight and gestational age for apnea of prematurity group was 1094•07 gm and 30•0 wks respectively. Survival rate for babies with apnea of prematurity (71•42%) was better than babies with infection (42•3%). Conclusion: All babies born below 32 weeks of gestational age must undergo close monitoring for apnea. Neonates with apneic spells should be evaluated to exclude secondary causes of apnea like sepsis, hypoglycaemia and intracranial hemorrhage etc., because sepsis remains the commonest cause of apnea and carries a poor prognosis.