Home monitor follow-up of persistent apnea and bradycardia in preterm infants.

We reviewed our experience with home monitor observations of 83 preterm infants (postconceptional age, 36 to 44 weeks) who had persistent apnea, bradycardia, or cyanosis. Polygraphic recordings before discharge showed that 92% of these infants had cardiorespiratory abnormalities that included prolonged (greater than 20 s) apnea, excessive periodic breathing (greater than 15%), bradycardia (greater than 80 beats per minute), feeding hypoxemia, or elevated carbon dioxide values. At home, 70 infants had either no alarms or alarms that resolved spontaneously, while 13 (16%) had more serious episodes that required parental intervention, including mouth-to-mouth ventilation in one infant. While polygraphic studies were helpful in documenting specific cardiorespiratory abnormalities, neither these abnormalities nor the clinical characteristics of the infants identified those infants experiencing subsequent home monitor alarms requiring parental intervention. Our data suggest that some preterm infants with persistent episodes of apnea, bradycardia, and cyanosis beyond 36 weeks of postconceptional age remain at risk for future serious episodes for several months.