Apnoea in premature infants
Babies born prior to the thirty-seventh week of gestation may encounter numerous problems the severity of which may affect their ability to survive. Gestational age plays an important role because it is linked to the development of many organs, the lungs in particular. In 25% of premature babies and in over 80% of those newborns weighing less than 1 kg, there are frequent episodes of apnoea, generally 2-3 days after birth, which are mainly due to the underdevelopment of the respiratory system. Apnoea, which is the suspension of respiration for more than 20 seconds, can be associated with a slowing of the heart beat (bradycardia) and a reduction in the amount of oxygen in the blood (desaturation). In the event that apnoea lasts for some time, the infant may become pale or bluish with a reduction in muscle tone. Specific pathologies such as hypoglycaemia, hypocalcaemia, sepsis, intracranial haemorrhage and gastroesophageal reflux can also cause apnoea; as a result premature infants who experience a suspension in respiration must be carefully evaluated in order to exclude underlying conditions. Episodes of apnoea can be resolved with appropriate stimulants such as caffeine, for example, whilst in more serious cases artificial respiration is often required. Apnoea usually improves as the infant gets older until it disappears completely.