Neonatology pp 1021-1033 | Cite as

Apnea of Prematurity and Sudden Infant Death Syndrome

  • Christian F. PoetsEmail author
Reference work entry


Apnea of prematurity is a self-resolving, yet very common condition in preterm infants. Recent observational data suggest that the intermittent hypoxemia often occurring with it may be associated with an increased risk of adverse outcome, including cerebral palsy, retinopathy of prematurity, and death. Treatment should follow an incremental approach, starting with head elevated positioning, followed by caffeine administration and nasal respiratory support.

Sudden infant death syndrome has decreased markedly in incidence following primary prevention campaigns in many countries, yet continues to be a leading cause of death beyond the neonatal period. Although still incompletely understood, it seems that death is the result of an external trigger (e.g., prone sleep position) occurring in a vulnerable infant (e.g., born to a mother who smoked during pregnancy) during a critical developmental period (e.g., 2–4 months of age). Memory monitor recordings obtained during SIDS suggest that bradycardia, probably resulting from severe hypoxemia, is the primary abnormality in the sequence of events ultimately resulting in these deaths. Prevention should focus on a safe sleep environment, i.e., supine sleep position, a smoke-free environment, avoidance of overheating, use of a sleeping bag, and room but not bed sharing.

List of Abbreviations


American Academy of Pediatrics


Apparent life-threatening event


Apnea of prematurity


Bronchopulmonary dysplasia


Centers for Disease Control


Confidence interval


Carbon dioxide


Intermittent hypoxemia




Medium-chain acyl-CoA dehydrogenase


Nasal continuous positive airway pressure


Nasal intermittent positive pressure ventilation


Number needed to treat


Odds ratio


Partial pressure of oxygen in arterial blood


Population-attributable risk


Randomized controlled trial


Retinopathy of prematurity


Relative risk


Sudden infant death syndrome


Arterial oxygen saturation measured by pulse oximetry


Total parenteral nutrition


Very low birth weight


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeonatologyTübingen University HospitalTübingenGermany

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