Response From Committee on Fetus and Newborn

Eichenwald, Eric C.; Newborn,

doi:10.1542/peds.2016-0403b

Cited by 26 publications

(34 citation statements)

References 4 publications

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“…Our study has several limitations in that, it is a single center observational study and all our polysomnography studies were read by a single clinicians which may introduce some bias but our data show that we are in line with other published literature and our conclusions are consistent with current AAP recommendations [ 19 – 21 , 24 , 25 ].…”

Section: Discussionsupporting

confidence: 86%

Impact of Infant-Polysomnography Studies on Discharge Management and Outcomes: A 5 Year Experience from a Tertiary Care Unit

et al. 2017

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Objective To evaluate the impact of infant-polysomnography studies performed in the NICU on management and outcomes. Study design Retrospective study to collect demographics and data on infant-polysomnography studies between Jan 2010 to Dec 2014. Results 110 premature neonates had polysomnography study performed at 36.9 ± 2.5 weeks post menstrual age. Almost all the studies were read as abnormal and 95% of the studied infants were discharged home on a cardiorespiratory monitor. 20% of the subjects had apnea >20 s, 18% had apnea of 15–20 s and 50% of infants had apnea of 10–15 s. 24.5% infants were discharged home on caffeine, 28% on metoclopramide and 24% on antacids. There were 11 readmissions for apparent life threatening events with no until 6 month-corrected age. There was no association between polysomnography results and readmission. There was a decline in polysomnography studies performed each year. Conclusion Cardiorespiratory monitoring, medications and polysomnography studies do not predict outcomes.

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Section: Discussionsupporting

confidence: 86%

Impact of Infant-Polysomnography Studies on Discharge Management and Outcomes: A 5 Year Experience from a Tertiary Care Unit

et al. 2017

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“…17,18 In our cohort, we identified central apnea events in 63% of infants < 34 weeks' EGA and nearly all infants < 28 weeks' EGA, which is consistent with other published data. 1,2,4 We considered whether clinical variables potentially impacting occurrence of apnea might have differed in male versus female infants in our cohort, thus biasing the results. This was not the case for the diagnoses of necrotizing enterocolitis, intraventricular hemorrhage, or periventricular leukomalacia, which did not differ by sex.…”

Section: Discussionmentioning

confidence: 99%

Central Apnea of Prematurity: Does Sex Matter?

et al. 2020

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Objective Apnea is common among infants in the neonatal intensive care unit (NICU). Our group previously developed an automated algorithm to quantitate central apneas with associated bradycardia and desaturation (ABDs). Sex differences in lung disease are well described in preterm infants, but the influence of sex on apnea has not been established. Study Design This study includes infants < 34 weeks' gestation admitted to the University of Virginia NICU from 2009 to 2014 with at least 1 day of bedside monitor data available when not on mechanical ventilation. Waveform and vital sign data were analyzed using a validated algorithm to detect ABD events of low variance in chest impedance signal lasting at least 10 seconds with associated drop in heart rate to < 100 beats/minute and drop in oxygen saturation to < 80%. Male and female infants were compared for prevalence of at least one ABD event during the NICU stay, treatment with caffeine, occurrence of ABDs at each week of postmenstrual age, and number of events per day. Results Of 926 infants studied (median gestational age 30 weeks, 53% male), median days of data analyzed were 19 and 22 for males and females, respectively. There was no sex difference in prevalence of at least one ABD event during the NICU stay (males 62%, females 64%, p = 0.47) or in the percentage of infants treated with caffeine (males 64%, females 67%, p = 0.40). Cumulative prevalence of ABDs from postmenstrual ages 24 to 36 weeks was comparable between sexes. Males had 18% more ABDs per day of data, but this difference was not statistically significant (p = 0.16). Conclusion In this large cohort of infants < 34 weeks' gestation, we did not detect a sex difference in prevalence of central ABD events. There was a nonsignificant trend toward a greater number of ABDs per day in male infants. Key Points

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“…Despite the paucity of evidence and based on recommendations from the American Academy of Pediatrics, 82 the GDG members recommend CPAP therapy for the management of apnea in preterm neonates considering the beneficial effects of CPAP…”

Section: Questions Evidence Summary and Recommendationsmentioning

confidence: 99%