NEMA Research Inc., Naples, Florida, USA.
Neumentum Inc., Summit, New Jersey, USA.
J Clin Pharm Ther. 2022 May;47(5):685-693. doi: 10.1111/jcpt.13587. Epub 2022 Jan 11.
Many premature infants less than 37 weeks gestational age (GA), and almost all infants less than 28 weeks GA, will experience apnoea of prematurity (AOP)-a cessation of respiration for 20 or more seconds (or less than 20 s if accompanied by other signs). Because the treatment options for AOP are so limited, we explore its epidemiology, with the ultimate hope of learning how to decrease its incidence.
Although AOP usually resolves with maturation of the respiratory system, many short- and long-term negative effects are correlated statistically with AOP (although direct causality has not been established). The primary risk factor for AOP is preterm birth, but delivery technique, genetics, socioeconomic status, racial disparities and other influences are suspected to be involved. Anaemia, asthma and gastric reflux have also been associated with preterm birth, but the relationship with AOP is unclear. The postulated associations and the strength of the evidence are briefly reviewed and discussed.
Attempts to elucidate the epidemiology of apnoea of prematurity have been challenging. Studies of AOP are hampered in part by challenges in monitoring the condition, the interplay of multiple comorbidities in preterm neonates and lack of expert consensus definitions. However, since the primary risk factor is preterm birth, efforts to decrease the prevalence of preterm birth would have a positive secondary effect on the prevalence of AOP. Until then, better pharmacotherapeutic options are needed.
许多胎龄小于 37 周的早产儿（GA），以及几乎所有胎龄小于 28 周的婴儿，都会经历早产儿呼吸暂停（AOP）——呼吸停止 20 秒以上（如果伴有其他体征，则少于 20 秒）。由于 AOP 的治疗选择非常有限，我们探索其流行病学，最终希望学习如何降低其发病率。
尽管 AOP 通常随着呼吸系统的成熟而解决，但许多短期和长期的负面影响与 AOP 呈统计学相关（尽管尚未确立直接因果关系）。AOP 的主要危险因素是早产，但分娩技术、遗传、社会经济地位、种族差异和其他因素也被怀疑与之相关。贫血、哮喘和胃食管反流也与早产有关，但与 AOP 的关系尚不清楚。简要回顾和讨论了假定的关联及其证据强度。
阐明早产儿呼吸暂停的流行病学一直具有挑战性。AOP 的研究部分受到监测该病症的挑战、早产儿多种合并症的相互作用以及缺乏专家共识定义的阻碍。然而，由于主要的危险因素是早产，因此减少早产的发生率将对 AOP 的发生率产生积极的次要影响。在那之前，需要更好的药物治疗选择。
