Early childhood neurodevelopment in very low birth weight infants with predischarge apnea

Apnea commonly occurs in preterm infants and may persist beyond term. We pr ospectively investigated the relationship between apnea that persisted beyo nd 35 weeks postconceptional age and subsequent neurodevelopment in early c hildhood. Between January, 1990-November, 1993, we performed predischarge r espiratory recordings, using 24-hr, 4-channel pneumography, at 35 weeks or more of postconceptional age in 164 infants (birth weight, <1,250 g; gestat ional age, less than or equal to 32 weeks), who subsequently underwent mult idisciplinary neurodevelopmental assessment at 15-64 (median 24) months of adjusted age. The duration of initial artificial ventilation for respiratory distress syn drome and the grade of intraventricular hemorrhage were independent predict ors of neurodevelopmental outcome. Mean oximetry desaturation and frequency of predischarge apnea correlated with mental and motor developmental score s. Mean oximetry desaturation during apnea was an independent predictor for motor score in the total population, and for both mental and motor scores in 50 infants with grade 3 or 4 intraventricular hemorrhage, but not in 114 infants without grade 3 or 4 intraventricular hemorrhage. Despite its limi ted predictability for early childhood neurodevelopment, predischarge respi ratory recordings may be useful in predicting subsequent neurodevelopment o f high-risk preterm infants, especially those with severe intraventricular hemorrhage. Pediatr Pulmonol, 1999; 27:14-20, (C) 1999 Wiley-Liss. Inc.