Definition

Apnea of prematurity is a brief stop in breathing in babies born before 35 weeks of pregnancy. It lasts 15 to 20 seconds. The brief stop may be less than 15 seconds if the baby has a slow heart rate or turns blue or pale.

Causes

This problem may be caused by an immature nervous system, weak breathing muscles, or a mix of both.

The brain controls breathing. It should sense the need to breathe and tell the body to do it. Young nervous systems may not be able to do this. This is called central apnea.

Premature babies may also have weak breathing muscles. They cannot support the airway and keep it open. This makes it hard to breathe. This is called obstructive apnea.

Normal Upper Airway During Sleep Copyright © Nucleus Medical Media, Inc.

Risk Factors

This problem is more common in babies born before 35 weeks of pregnancy. The risk is greater the earlier a baby is born.

Other things that may raise the risk are:

• Genetics
• Cesarean delivery
• Conception through fertility treatments
• Lack of red blood cells (anemia)
• Gastroesophageal reflux

Symptoms

Symptoms happen in the first week of life. They may be:

• Long pauses between breaths
• Bluish skin color
• Slow heart rate

Diagnosis

The doctor will ask about your baby's symptoms and health history. A physical will be done. It will focus on your baby's breathing and heart rate.

Blood tests will be done.

Images may be taken of your baby's chest, belly, and head. This can be done with:

• X-ray
• Ultrasound

Treatment

Apnea will go away on its own as a baby reaches what would have been the 36th week of pregnancy.

Treatment may be needed to manage symptoms until the apnea goes away. This is often done in the hospital. Choices are:

• Rubbing or patting the baby to get breathing started again
• Medicines to help with breathing, such as caffeine
• Breathing support, such as a continuous positive airway pressure (CPAP) machine to help take over breathing if there is a long pause

Prevention

There are no known methods to prevent this health problem.