Original articlesHome apnea monitor use in preterm infants discharged from newborn intensive care units*
Section snippets
Study Population
This was a descriptive, cross-sectional, epidemiologic study designed to describe the factors associated with discharge of an infant from the neonatal intensive care unit with a home apnea monitor. Neonates discharged from neonatal intensive care units managed by Pediatrix Medical Group, Inc, between January 1, 1998, and January 31, 2000, who were ≤34 weeks’ estimated gestational age were eligible for inclusion in the study. A total of 18,584 neonates were discharged from 98 neonatal units. We
Results
Eleven percent of infants were sent home with monitors (Table I). Site variation in use of home apnea monitors at discharge ranged from 0% to 57%. Univariate analysis showed that the following factors were associated with increased monitor use: decreasing birth weight and gestational age, white race, being outborn (ie, born at site other than the final site of neonatal care), cesarean delivery, need for assisted ventilation on day 1, a diagnosis of apnea, a history of treatment with
Discussion
We show that site of birth influences monitor use more than any other variable. Other variables that were important included gestational age, birth weight, being outborn, a history of apnea, and a history of treatment with methylxanthines. We did not find an association between monitor use and earlier hospital discharge.
We expected that gestational age would affect monitor use because more immature (and frequently sicker) neonates are more likely to develop problems with apnea and are at higher
Acknowledgements
In addition to the authors, the following physicians participated: K. Lorah (Harrisburg, PA); M. Siriwardena (Utica, NY); E. Otero and C. Smart (Wichita, KS); S. Haskins (Ft Lauderdale, FL); F. Miller (Boca Raton, FL); G. Melnick (Coral Springs, FL); L. Whetstine (Boynton Beach, FL); E. Berman, D. Eichorst, J. Toney, and P. Honeyfield (Denver, CO); R. Rivas, H. Pierantoni, and E. O’Donnell (Houston, TX); K. Zarlengo (Englewood, CO); D. Kanter (West Palm Beach, FL); R. Balcom and E. Bollerup
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Cited by (19)
Sudden Infant Death Syndrome and Apparent Life-Threatening Events
2012, Kendig and Chernick's Disorders of the Respiratory Tract in ChildrenIndications for Home Apnea Monitoring (or Not)
2009, Clinics in PerinatologyCitation Excerpt :Despite the American Academy of Pediatrics' definition of AOP (cessation of breathing that lasts for 20 seconds or is associated with bradycardia, oxygen desaturation, cyanosis in an infant younger than 37 weeks' gestational age),2 management is variable, depending on the NICU of birth.3,4
Apnea of Prematurity
2008, Primary Care of the Premature InfantApnea of Prematurity
2007, Primary Care of the Premature InfantApnea of prematurity: risk factors and ambulatory treatment with caffeine citrate
2006, Archives de PediatrieSudden Infant Death Syndrome and Acute Life-Threatening Events
2006, Kendig's Disorders of the Respiratory Tract in Children
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Reprint requests: Reese H. Clark, MD, Director of Research, Pediatrix Medical Group, Inc, 1301 Concord Terr, Sunrise, FL 33323-2825.