Document Detail


Ontogeny of autonomic regulation in late preterm infants born at 34-37 weeks postmenstrual age.
MedLine Citation:
PMID:  16731280     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Late preterm infants (34-37 weeks postmenstrual age at birth) are intermediate between less mature preterm infants and infants born at 38 weeks or more in regard to autonomic brain stem maturation. Ventilatory responses to CO(2) in preterm infants born at 33 to 36 week are significantly higher than in infants born at 29 to 32 weeks both at 3 to 4 and 10 to 14 days postnatal age, but do not differ from full-term reference levels. The ventilatory response to hypoxia in preterm infants is biphasic; initial transient hyperventilation is followed by a return to baseline and then a decrease below baseline. In infants born at 32 to 37 weeks, parasympathetic maturation appears significantly less than in full-term infants based on diminished increases in high frequency heart rate variability in quiet sleep, suggesting that late preterm infants are still more susceptible to bradycardia than full-term infants. Both the presence and severity of apnea of prematurity progressively decrease the higher the postmenstrual age. Late preterm infants, however, are still at risk, with prevalence rates as high as 10% compared with about 60% in infants born at <1500 g. The incidence of apparent life-threatening events is more common in preterm infants (8-10%) than full-term infants (1% or less). In the Collaborative Home Infant Monitoring Evaluation studies, the frequency of conventional and extreme events in near term infants is intermediate between preterm infants <34 weeks at birth and full-term infants. The relative risk for at least one extreme event in late preterm infants is increased (5.6 and 7.6, respectively, P < 0.008) compared with full-term infants and remains higher until 43 weeks postmenstrual age. The rate for Sudden Infant Death Syndrome in preterm infants born at 33 to 36 weeks is 1.37/1000 live births compared with 0.69 in infants born full term. Affected late preterm infants die at a older mean postmenstrual age compared with less mature infants (48 and 46 weeks, respectively), but die at a younger postmenstrual age than full-term infants (53 weeks, P < 0.05).
Authors:
Carl E Hunt
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in perinatology     Volume:  30     ISSN:  0146-0005     ISO Abbreviation:  Semin. Perinatol.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-05-29     Completed Date:  2006-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7801132     Medline TA:  Semin Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  73-6     Citation Subset:  IM    
Affiliation:
Uniformed Services University of the Health Sciences, Bethesda, MD 20892, USA. huntc@nhlbi.nih.gov
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MeSH Terms
Descriptor/Qualifier:
Apnea / etiology*
Bradycardia / epidemiology,  etiology*
Female
Gestational Age
Humans
Infant, Newborn
Infant, Premature / physiology*
Infant, Premature, Diseases / epidemiology,  etiology
Menstrual Cycle
Pregnancy
Respiration
Sudden Infant Death / epidemiology,  etiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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