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Apnea of prematurity

MedGen UID:
473179
•Concept ID:
C0475715
•
Pathologic Function
Synonyms: AOP; Apnea of Prematurity; apnea of prematurity
SNOMED CT: Apnea of prematurity (276544005)
Modes of inheritance:
Not genetically inherited
MedGen UID:
988794
•Concept ID:
CN307044
•
Finding
Source: Orphanet
clinical entity without genetic inheritance.
See: This record
Not genetically inherited (Orphanet)
 
HPO: HP:0034236
Monarch Initiative: MONDO:0020567
Orphanet: ORPHA99981

Definition

Recurrent episodes of apnea occurring in infants born less than 37 weeks of gestation, defined specifically as a pause of breathing for more than 15-20 s, or accompanied by oxygen desaturation (SpO2 not more than 80% for at least 4 s) and bradycardia (heart rate less than 2/3 of baseline for at least 4 s), in infants born less than 37 weeks of gestation. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVApnea of prematurity
Follow this link to review classifications for Apnea of prematurity in Orphanet.

Professional guidelines

PubMed

Methylxanthine for the prevention and treatment of apnea in preterm infants.
Marques KA, Bruschettini M, Roehr CC, Davis PG, Fiander M, Soll R
Cochrane Database Syst Rev 2023 Oct 31;10(10):CD013830. doi: 10.1002/14651858.CD013830.pub2. PMID: 37905735Free PMC Article
Doxapram for the prevention and treatment of apnea in preterm infants.
Evans S, Avdic E, Pessano S, Fiander M, Soll R, Bruschettini M
Cochrane Database Syst Rev 2023 Oct 25;10(10):CD014145. doi: 10.1002/14651858.CD014145.pub2. PMID: 37877431Free PMC Article
Caffeine versus other methylxanthines for the prevention and treatment of apnea in preterm infants.
Moresco L, Sjögren A, Marques KA, Soll R, Bruschettini M
Cochrane Database Syst Rev 2023 Oct 4;10(10):CD015462. doi: 10.1002/14651858.CD015462.pub2. PMID: 37791592Free PMC Article

Recent clinical studies

Etiology

Caffeine dosing regimens in preterm infants with or at risk for apnea of prematurity.
Bruschettini M, Brattström P, Russo C, Onland W, Davis PG, Soll R
Cochrane Database Syst Rev 2023 Apr 11;4(4):CD013873. doi: 10.1002/14651858.CD013873.pub2. PMID: 37040532Free PMC Article
Comparative efficacy and safety of caffeine citrate and aminophylline in treating apnea of prematurity: A systematic review and meta-analysis.
Miao Y, Zhou Y, Zhao S, Liu W, Wang A, Zhang Y, Li Y, Jiang H
PLoS One 2022;17(9):e0274882. Epub 2022 Sep 19 doi: 10.1371/journal.pone.0274882. PMID: 36121807Free PMC Article
Caffeine controversies.
Gentle SJ, Travers CP, Carlo WA
Curr Opin Pediatr 2018 Apr;30(2):177-181. doi: 10.1097/MOP.0000000000000588. PMID: 29346141
Hypoxic Episodes in Bronchopulmonary Dysplasia.
Martin RJ, Di Fiore JM, Walsh MC
Clin Perinatol 2015 Dec;42(4):825-38. doi: 10.1016/j.clp.2015.08.009. PMID: 26593081Free PMC Article
Caffeine therapy for apnea of prematurity.
Schmidt B, Roberts RS, Davis P, Doyle LW, Barrington KJ, Ohlsson A, Solimano A, Tin W; Caffeine for Apnea of Prematurity Trial Group
N Engl J Med 2006 May 18;354(20):2112-21. doi: 10.1056/NEJMoa054065. PMID: 16707748

Diagnosis

Immature control of breathing and apnea of prematurity: the known and unknown.
Erickson G, Dobson NR, Hunt CE
J Perinatol 2021 Sep;41(9):2111-2123. Epub 2021 Mar 12 doi: 10.1038/s41372-021-01010-z. PMID: 33712716Free PMC Article
Apnea of Prematurity.
Eichenwald EC; Committee on Fetus and Newborn, American Academy of Pediatrics
Pediatrics 2016 Jan;137(1) Epub 2015 Dec 1 doi: 10.1542/peds.2015-3757. PMID: 26628729
Apnea of prematurity--perfect storm.
Di Fiore JM, Martin RJ, Gauda EB
Respir Physiol Neurobiol 2013 Nov 1;189(2):213-22. Epub 2013 May 28 doi: 10.1016/j.resp.2013.05.026. PMID: 23727228
Apnea of prematurity.
Miller MJ, Martin RJ
Clin Perinatol 1992 Dec;19(4):789-808. PMID: 1464191
Doxapram in the treatment of idiopathic apnea of prematurity: desirable dosage and serum concentrations.
Hayakawa F, Hakamada S, Kuno K, Nakashima T, Miyachi Y
J Pediatr 1986 Jul;109(1):138-40. doi: 10.1016/s0022-3476(86)80594-7. PMID: 3723234

Therapy

Caffeine dosing regimens in preterm infants with or at risk for apnea of prematurity.
Bruschettini M, Brattström P, Russo C, Onland W, Davis PG, Soll R
Cochrane Database Syst Rev 2023 Apr 11;4(4):CD013873. doi: 10.1002/14651858.CD013873.pub2. PMID: 37040532Free PMC Article
Comparative efficacy and safety of caffeine citrate and aminophylline in treating apnea of prematurity: A systematic review and meta-analysis.
Miao Y, Zhou Y, Zhao S, Liu W, Wang A, Zhang Y, Li Y, Jiang H
PLoS One 2022;17(9):e0274882. Epub 2022 Sep 19 doi: 10.1371/journal.pone.0274882. PMID: 36121807Free PMC Article
Caffeine controversies.
Gentle SJ, Travers CP, Carlo WA
Curr Opin Pediatr 2018 Apr;30(2):177-181. doi: 10.1097/MOP.0000000000000588. PMID: 29346141
Caffeine citrate therapy for apnea of prematurity.
Johnson PJ
Neonatal Netw 2011 Nov-Dec;30(6):408-12. doi: 10.1891/0730-0832.30.6.408. PMID: 22052121
Caffeine therapy for apnea of prematurity.
Schmidt B, Roberts RS, Davis P, Doyle LW, Barrington KJ, Ohlsson A, Solimano A, Tin W; Caffeine for Apnea of Prematurity Trial Group
N Engl J Med 2006 May 18;354(20):2112-21. doi: 10.1056/NEJMoa054065. PMID: 16707748

Prognosis

Self-reported Quality of Life at Middle School Age in Survivors of Very Preterm Birth: Results From the Caffeine for Apnea of Prematurity Trial.
Schmidt B, Anderson PJ, Asztalos EV, Doyle LW, Grunau RE, Moddemann D, Roberts RS
JAMA Pediatr 2019 May 1;173(5):487-489. doi: 10.1001/jamapediatrics.2018.4853. PMID: 30830144Free PMC Article
What is the basis for a genetic approach in neonatal disorders?
Bhandari V, Gruen JR
Semin Perinatol 2015 Dec;39(8):568-73. Epub 2015 Oct 23 doi: 10.1053/j.semperi.2015.09.003. PMID: 26471062
Apnea of prematurity.
Martin RJ, Wilson CG
Compr Physiol 2012 Oct;2(4):2923-31. doi: 10.1002/cphy.c100021. PMID: 23720269
What does the preterm infant breathe for? Controversies on apnea of prematurity.
Lagercrantz H
Acta Paediatr 1992 Oct;81(10):733-6. doi: 10.1111/j.1651-2227.1992.tb12092.x. PMID: 1358291
The xanthine treatment of apnea of prematurity.
Lucey JF
Pediatrics 1975 May;55(5):584-6. PMID: 1128983

Clinical prediction guides

Early versus Late Caffeine Therapy Administration in Preterm Neonates: An Updated Systematic Review and Meta-Analysis.
Karlinski Vizentin V, Madeira de Sá Pacheco I, Fahel Vilas Bôas Azevêdo T, Florêncio de Mesquita C, Alvim Pereira R
Neonatology 2024;121(1):7-16. Epub 2023 Nov 21 doi: 10.1159/000534497. PMID: 37989113
Caffeine dosing regimens in preterm infants with or at risk for apnea of prematurity.
Bruschettini M, Brattström P, Russo C, Onland W, Davis PG, Soll R
Cochrane Database Syst Rev 2023 Apr 11;4(4):CD013873. doi: 10.1002/14651858.CD013873.pub2. PMID: 37040532Free PMC Article
Caffeine not associated with irritable behaviour in very low-birth-weight infants.
Maeda T, Sekiguchi K, Wasada R, Ihara K
Early Hum Dev 2019 Oct;137:104835. Epub 2019 Aug 29 doi: 10.1016/j.earlhumdev.2019.104835. PMID: 31473373
Neuroprotection of the preterm brain.
Fleiss B, Gressens P
Handb Clin Neurol 2019;162:315-328. doi: 10.1016/B978-0-444-64029-1.00015-1. PMID: 31324318
Doxapram Treatment for Apnea of Prematurity: A Systematic Review.
Vliegenthart RJ, Ten Hove CH, Onland W, van Kaam AH
Neonatology 2017;111(2):162-171. Epub 2016 Oct 20 doi: 10.1159/000448941. PMID: 27760427Free PMC Article

Recent systematic reviews

Early versus Late Caffeine Therapy Administration in Preterm Neonates: An Updated Systematic Review and Meta-Analysis.
Karlinski Vizentin V, Madeira de Sá Pacheco I, Fahel Vilas Bôas Azevêdo T, Florêncio de Mesquita C, Alvim Pereira R
Neonatology 2024;121(1):7-16. Epub 2023 Nov 21 doi: 10.1159/000534497. PMID: 37989113
Methylxanthine for the prevention and treatment of apnea in preterm infants.
Marques KA, Bruschettini M, Roehr CC, Davis PG, Fiander M, Soll R
Cochrane Database Syst Rev 2023 Oct 31;10(10):CD013830. doi: 10.1002/14651858.CD013830.pub2. PMID: 37905735Free PMC Article
Doxapram for the prevention and treatment of apnea in preterm infants.
Evans S, Avdic E, Pessano S, Fiander M, Soll R, Bruschettini M
Cochrane Database Syst Rev 2023 Oct 25;10(10):CD014145. doi: 10.1002/14651858.CD014145.pub2. PMID: 37877431Free PMC Article
Caffeine dosing regimens in preterm infants with or at risk for apnea of prematurity.
Bruschettini M, Brattström P, Russo C, Onland W, Davis PG, Soll R
Cochrane Database Syst Rev 2023 Apr 11;4(4):CD013873. doi: 10.1002/14651858.CD013873.pub2. PMID: 37040532Free PMC Article
Comparative efficacy and safety of caffeine citrate and aminophylline in treating apnea of prematurity: A systematic review and meta-analysis.
Miao Y, Zhou Y, Zhao S, Liu W, Wang A, Zhang Y, Li Y, Jiang H
PLoS One 2022;17(9):e0274882. Epub 2022 Sep 19 doi: 10.1371/journal.pone.0274882. PMID: 36121807Free PMC Article

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