Short-term respiratory outcomes in late preterm infants

Abstract Objective The study compares the short-term outcomes of late preterm infants (LPI) at an academic center in San Diego, California after a change in protocol that eliminated a previously mandatory 12-hour neonatal intensive care unit (NICU) observation period after birth. Study Design This is a retrospective observational study examining all LPI born with gestational age 35 to 366/7 weeks between October 1, 2016 and October 31, 2017. A total of 189 infants were included in the review. Short-term outcomes were analyzed before and after the protocol change. Results Transfers to the NICU from family-centered care (FCC) were considerably higher (23.2%) following the protocol change, compared to before (8.2%). More infants were transferred to the NICU for failed car seat tests postprotocol compared to preprotocol. Length of stay before the protocol change was 5.13 days compared to 4.80 days after. Conclusion LPI are vulnerable to morbidities after delivery and through discharge. We found an increase in failed car seat tests in LPI cared for in FCC after elimination of a mandatory NICU observation after birth. The transitions of care from delivery to discharge are key checkpoints in minimizing complications.

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Late Preterm Infants at Risk for Short-Term and Long-Term Morbidity and Mortality

Neonatology ◽

10.1007/978-3-319-29489-6_159 ◽

2018 ◽

pp. 171-182

Author(s):

Avroy A. Fanaroff

Keyword(s):

At Risk ◽

Preterm Infants ◽

Late Preterm ◽

Morbidity And Mortality ◽

Short Term ◽

Late Preterm Infants

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1344 Respiratory Outcomes of Late Preterm Infants

Pediatric Research ◽

10.1203/00006450-201011001-01344 ◽

2010 ◽

Vol 68 ◽

pp. 665-666

Author(s):

M Colombo ◽

M Natile ◽

T Fedeli ◽

A Locatelli ◽

P Tagliabue ◽

...

Keyword(s):

Preterm Infants ◽

Late Preterm ◽

Late Preterm Infants ◽

Respiratory Outcomes

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Respiratory outcomes of late preterm infants of mothers with early and late onset preeclampsia

Journal of Perinatology ◽

10.1038/s41372-019-0497-4 ◽

2019 ◽

Vol 40 (1) ◽

pp. 39-45

Author(s):

Yasser Soliman ◽

Belal Alshaikh ◽

Essa Alawad ◽

Albert Akierman ◽

Adel Elsharkawy ◽

...

Keyword(s):

Preterm Infants ◽

Late Onset ◽

Late Preterm ◽

Late Preterm Infants ◽

Respiratory Outcomes

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Caffeine is a respiratory stimulant without effect on sleep in the short-term in late-preterm infants

Pediatric Research ◽

10.1038/s41390-021-01794-y ◽

2021 ◽

Author(s):

Maija Seppä-Moilanen ◽

Sture Andersson ◽

Turkka Kirjavainen

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Preterm Infants ◽

Sleep Stage ◽

Late Preterm ◽

Short Term ◽

Late Preterm Infants ◽

Stage Distribution ◽

Caffeine Treatment ◽

Respiratory Stimulant

Abstract Background Caffeine is widely used in preterm infants for apnea control. It has no effect on sleep in the only existing polysomnographic study including ten preterm infants Behavioral and polygraphic studies have conflicting results. Methods We studied 21 late-preterm infants at a median gestational age of 36 weeks. Polysomnography was performed twice, at baseline on day 1 and on the day after the onset of caffeine treatment (20 mg/kg loading and 5 mg/kg morning maintenance dose). Results Caffeine acted short term as a breathing stimulant with reduction of apneas, improved baseline SpO2 (p < 0.001), and decreased 95 percentile of end-tidal carbon dioxide level (p < 0.01). It also increased arousal frequency to SpO2 desaturations of more than 5% (p < 0.001). Caffeine did not affect sleep stage distribution, sleep efficiency, frequency of sleep stage transitions, appearance of REM periods, or the high number of spontaneous arousals. The median spontaneous arousal count was 18 per hour at baseline, and 16 per hour during caffeine treatment (p = 0.88). Conclusions In late-preterm infants, caffeine has a clear short-term respiratory stimulant effect, and it increases the arousal frequency to hypoxia. However, caffeine does not appear to act as a central nervous system stimulant, and it has no acute effect on sleep quality. Impact Effects of caffeine on sleep in preterm infants has previously been investigated with only one full polysomnographic study including ten preterm infants. The study showed no effect. The current study shows that caffeine acts short term as a respiratory stimulant and increases arousal frequency to hypoxia. Although a potent central nervous system (CNS) stimulant in adults, caffeine does not seem to have similar acute CNS effect in late-preterm infants. The onset of caffeine treatment has no short-term effect on sleep stage distribution, sleep efficiency, frequency of sleep stage transitions, appearance of REM periods, or the high number of spontaneous arousals.

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