Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
Monash Newborn, Monash Children's Hospital, Melbourne, Victoria, Australia.
Acta Paediatr. 2024 Jun;113(6):1298-1305. doi: 10.1111/apa.17166. Epub 2024 Feb 20.
Preterm infants are at increased risk of Sudden Infant Death Syndrome (SIDS) and frequently experience short central apnoeas which can occur in isolation or a repetitive pattern (periodic breathing). We investigated the relationship between central apnoeas experienced before and over the 6 months after hospital discharge and cerebral oxygenation.
Preterm infants born between 28 and 32 weeks gestational age (GA) were studied during supine daytime sleep at 32-36 weeks post menstrual age (PMA) (n = 40), 36-40 weeks PMA (n = 27), 3-months corrected age (CA) (n = 20) and 6-months CA (n = 26). Cerebral tissue oxygenation (TOI), peripheral oxygenation (SpO) and heart rate were recorded continuously. The percentage total sleep time (%TST) spent having central apnoeas at each study and cerebral fractional oxygen extraction (SpO-TOI/SpO) were calculated.
%TST spent with central apnoeas decreased with increasing age in both active sleep (AS) and quiet sleep (QS). TOI tended to be lower and cerebral fractional oxygen extraction higher at 3 months compared to the other studies and this reached statistical significance compared to 32-36 weeks in QS.
The nadir in cerebral tissue oxygenation at 3 months of age coincides with the peak risk period for SIDS and this may contribute to increased risk in these infants.
早产儿患婴儿猝死综合征（SIDS）的风险增加，经常会出现短暂的中枢性呼吸暂停，这种呼吸暂停可能是孤立发生的，也可能是反复发作的（周期性呼吸）。我们研究了出院后 6 个月内经历的中枢性呼吸暂停与脑氧合之间的关系。
研究了胎龄 28 至 32 周的早产儿，在仰卧位白天睡眠时进行研究，分别在出生后 32-36 周（末次月经龄，PMA）（n=40）、36-40 周 PMA（n=27）、3 个月校正年龄（CA）（n=20）和 6 个月 CA（n=26）时进行研究。连续记录脑组织氧合（TOI）、外周氧合（SpO）和心率。计算每个研究中中枢性呼吸暂停的总睡眠时间百分比（%TST）和脑氧摄取分数（SpO-TOI/SpO）。
在活跃睡眠（AS）和安静睡眠（QS）中，随着年龄的增长，中枢性呼吸暂停的%TST 逐渐减少。与其他研究相比，3 个月时的 TOI 趋于较低，脑氧摄取分数较高，与 QS 中的 32-36 周相比，这具有统计学意义。
3 个月龄时脑氧合的最低点与 SIDS 的最高风险期相吻合，这可能导致这些婴儿的风险增加。
