Health Encyclopedia

Apnea of prematurity

Alternative Names

Apnea - newborns; AOP; As and Bs; Blue spell - newborns; Dusky spell - newborns; Spell - newborns

Definition

Apnea of prematurity refers to short episodes of stopped breathing in babies born before term. Newborns, especially premies, often have a breathing pattern that is immature and irregular. These babies often stop breathing for short periods -- this is called apnea.

Causes, incidence, and risk factors

Several things contribute to apnea in newborns, especially premature babies. They include:

Immaturity of the brain
Weakness of the muscles that keep the airway open

Additional stresses in a sick or premature baby may worsen apnea. These include infection, heart or lung problems, anemia, low oxygen levels, temperature problems, feeding problems, and overstimulation.

Symptoms

The main symptom is short episodes of no breathing. They babies breathing may sometimes be described as “periodic,” with times of normal breathing that progress to very shallow breathing. When there is very shallow or no breathing (apnea), the baby may also have a drop in the heart rate. This heart rate drop is called bradycardia.

Some babies may also have poor color and ill-looking appearance.

Signs and tests

Because most preterm and some sick term babies have some degree of apnea, the babies are hooked up to monitors to watch their breathing and and heart rates. Babies with apnea or a drop in heart rate can set off alarms on these monitors.

In some cases, babies may simply be observed during episodes where they stop breathing.

Treatment

Treatment of apnea depends on the cause, how often the breathing stops, and the severity of spells. Babies who appear to be otherwise healthy with few spells per day are simply watched and can be gently stimulated during their occasional episodes.

Babies who are well that have multiple episodes of stopped breathing may be given a caffeine preparation to help stimulate their breathing.

Proper positioning, slower feeding time, oxygen, and (in extreme cases) a breathing machine may be needed to assist in breathing.

A baby with apnea is not released from the hospital until he or she can breathe easily without an interruption in breathing or heart rate.

Expectations (prognosis)

Apnea is common in premature babies and most have normal outcomes. While mild apena is not believed to have long-term effects, most doctors feel that prevention of multiple or severe episodes is better for the baby on the long term.

Review Date:11/14/2007
Reviewed By:Deirdre O’Reilly, M.D., M.P.H., Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.

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