Apnea of Prematurity Symptoms & Causes

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Contact for the Center of Healthy Infant Lung Development


Apnea of prematurity may have several causes, resulting in two main kinds of apnea:

  • Central apnea – this kind of apnea is due to a disturbance in a child’s brain's breathing control center. Problems in her organs might also affect this breathing control center.
  • Obstructive apnea – with this kind of apnea, a child’s breathing stops because something is blocking the child’s airway.

Apnea of prematurity may also be caused simply because a child has an immature central nervous system, or conditions including:

  • bleeding or tissue damage in your baby’s brain
  • respiratory disease
  • infections
  • gastrointestinal problems such as reflux (your baby’s stomach contents move back up into the esophagus)
  • your baby’s levels of chemicals such as glucose or calcium are too high or too low
  • heart or blood vessel problems
  • the stimulation of reflexes that can trigger apnea such as with feeding tubes or suctioning, or when your baby's neck is very flexed
  • unstable temperature

Who is affected by apnea of prematurity?

Most babies who develop apnea are premature. It appears to be more common during sleep, especially during active sleep--a period when your baby has rapid eye movement (REM) while sleeping.

What conditions are related to apnea of prematurity?

Apnea may be followed by bradycardia (decreased heart rate). With bradycardia, when your baby’s breathing slows, her heart rate also slows. A common term for apnea with bradycardia is "As and Bs."

What are the symptoms of apnea of prematurity?

While each baby may experience symptoms of apnea of prematurity differently, some of the most common include:

  • periods of absent breathing for 20 seconds or more
  • symptoms begin during in the first week of life or later

Signs of the more serious forms of apnea of prematurity may include:

  • longer periods of absent breathing
  • blue coloring
  • bradycardia
  • symptoms begin right after birth or after the second week

Apnea of prematurity or periodic breathing?

Apnea of prematurity may be confused with another breathing pattern called periodic breathing. Periodic breathing:

  • is a pattern of short pauses followed by a burst of faster breaths
  • may affect both premature and full-term babies
  • is a normal type of breathing in babies

Unlike periodic breathing, apnea of prematurity can be a symptom of a more serious condition.

The symptoms of apnea of prematurity may resemble other conditions or medical problems.

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