Clinical Profile of Apnea and Associated Conditions in Preterm Neonates: An Observational Study

Background Apnea in premature neonates is a common complication, particularly in extremely preterm neonates. This study aimed to describe the clinical profile and associated conditions of apnea in preterm neonates (less than 34 weeks) until discharge. Methods We conducted this prospective observational study in a tertiary care neonatal unit in Northern India. All preterm neonates born before 34 weeks of gestation were eligible for the study. Any neonate with apnea was investigated with blood glucose measurement, evaluation for sepsis, complete blood count, C-reactive protein (CRP) and blood culture, serum calcium, sodium, potassium, liver function tests and renal function tests, and venous blood gas. Clinical profile and management of enrolled neonates were recorded, and those with apnea were compared with those without apnea. Results Among the enrolled neonates, 130 (72.22%) neonates did not develop any apnea, while 50 (27.78%) neonates developed apnea. The mean day of life at first apnea was 5.74 ± 6.4, with a median (25th-75th percentile) of 3 days (2-5), while the mean day of life at last apnea was 23.2 ± 21.37, with a median (25th-75th percentile) of 21 days (7-30.75). Forty-six percent of cases of apnea were associated with gastroesophageal reflux, and 44% of cases were associated with hyponatremia. Other than universal caffeine usage, nasal continuous positive airway pressure (CPAP) was used in 45 (90%) cases. Conclusion Among the associated conditions of apnea, other than prematurity, gastroesophageal reflux and hyponatremia were the most common associations with apnea. Caffeine and nasal CPAP were the most commonly used treatment modalities for apnea.