Study note
PediatricsNewborn Care

Neonatal apnea and apnea of prematurity

THE CONTEXT
Neonatal apnea is defined by the duration of a breathing pause or its association with cyanosis or bradycardia.

Definition and mechanisms

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Apnea denotes cessation of breathing for 20 seconds, or a shorter pause if accompanied by cyanosis or bradycardia.
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Central apnea results from decreased central drive.
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Obstructive apnea results from neck flexion or airway secretions.
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Mixed apnea involves both mechanisms and is the most common type.

Apnea of prematurity

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Apnea of prematurity is the most common cause of apnea in preterm neonates and occurs between the second and fifth days of life.
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It results from immaturity of the respiratory center.
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Treatment is supportive, with caffeine or aminophylline advised; the prognosis is good.

Timing suggesting a secondary cause

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Apnea within the first 24 hours or after seven days of birth is more likely to be secondary.
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Treatment and prognosis for secondary apnea depend on the underlying cause.
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