Prospective pneumogram recordings in preterm infants with and without clinical apnea and bradycardia

Recordings of breathing movements and heart rate (pneumograms) were obtained prospectively in 89 preterm infants at 0-28 days of age to determine if those who develop apnea and/or bradycardia with cyanosis (Group 1) differ from those who do not (Group 2). The 148 pneumograms were blindly analyzed for periodic breathing, bradycardia, longest apnea, and quiet time. Pneumograms were compared between groups at weekly intervals during the first 4 weeks. Significant differences were found among infants who had pneumograms recorded during the 1st week of life. Although mean gestational age and mean postconceptional age at recording were similar, birthweight and weight at recording were significantly lower in Group 1 infants. Total time spent in periodic breathing and the longest episode of periodic breathing were significantly greater in Group 1 infants. Logistic regression analysis revealed significant independent relationships between birthweight and periodic breathing at less than or equal to 7 days of age and the occurrence of symptomatic apnea and/or bradycardia. It is concluded that preterm infants who develop apnea and/or bradycardia with cyanosis have a lower mean birthweight and mean weight at recording at less than or equal to 7 days of age than similar asymptomatic preterm infants. Periodic breathing at less than or equal to 7 days of age is associated with the occurrence of clinical symptoms of apnea and/or bradycardia. Normal pneumogram values for groups of 6-21 asymptomatic preterm infants are provided for the first 4 weeks of life.