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Ontogeny of autonomic regulation in late preterm infants born at 34-37 weeks postmenstrual age.
Semin Perinatol 2006; 30(2):73-6SP

Abstract

Late preterm infants (34-37 weeks postmenstrual age at birth) are intermediate between less mature preterm infants and infants born at 38 weeks or more in regard to autonomic brain stem maturation. Ventilatory responses to CO(2) in preterm infants born at 33 to 36 week are significantly higher than in infants born at 29 to 32 weeks both at 3 to 4 and 10 to 14 days postnatal age, but do not differ from full-term reference levels. The ventilatory response to hypoxia in preterm infants is biphasic; initial transient hyperventilation is followed by a return to baseline and then a decrease below baseline. In infants born at 32 to 37 weeks, parasympathetic maturation appears significantly less than in full-term infants based on diminished increases in high frequency heart rate variability in quiet sleep, suggesting that late preterm infants are still more susceptible to bradycardia than full-term infants. Both the presence and severity of apnea of prematurity progressively decrease the higher the postmenstrual age. Late preterm infants, however, are still at risk, with prevalence rates as high as 10% compared with about 60% in infants born at <1500 g. The incidence of apparent life-threatening events is more common in preterm infants (8-10%) than full-term infants (1% or less). In the Collaborative Home Infant Monitoring Evaluation studies, the frequency of conventional and extreme events in near term infants is intermediate between preterm infants <34 weeks at birth and full-term infants. The relative risk for at least one extreme event in late preterm infants is increased (5.6 and 7.6, respectively, P < 0.008) compared with full-term infants and remains higher until 43 weeks postmenstrual age. The rate for Sudden Infant Death Syndrome in preterm infants born at 33 to 36 weeks is 1.37/1000 live births compared with 0.69 in infants born full term. Affected late preterm infants die at a older mean postmenstrual age compared with less mature infants (48 and 46 weeks, respectively), but die at a younger postmenstrual age than full-term infants (53 weeks, P < 0.05).

Authors+Show Affiliations

Uniformed Services University of the Health Sciences, Bethesda, MD 20892, USA. huntc@nhlbi.nih.gov

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16731280

Citation

Hunt, Carl E.. "Ontogeny of Autonomic Regulation in Late Preterm Infants Born at 34-37 Weeks Postmenstrual Age." Seminars in Perinatology, vol. 30, no. 2, 2006, pp. 73-6.
Hunt CE. Ontogeny of autonomic regulation in late preterm infants born at 34-37 weeks postmenstrual age. Semin Perinatol. 2006;30(2):73-6.
Hunt, C. E. (2006). Ontogeny of autonomic regulation in late preterm infants born at 34-37 weeks postmenstrual age. Seminars in Perinatology, 30(2), pp. 73-6.
Hunt CE. Ontogeny of Autonomic Regulation in Late Preterm Infants Born at 34-37 Weeks Postmenstrual Age. Semin Perinatol. 2006;30(2):73-6. PubMed PMID: 16731280.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ontogeny of autonomic regulation in late preterm infants born at 34-37 weeks postmenstrual age. A1 - Hunt,Carl E, PY - 2006/5/30/pubmed PY - 2006/10/27/medline PY - 2006/5/30/entrez SP - 73 EP - 6 JF - Seminars in perinatology JO - Semin. Perinatol. VL - 30 IS - 2 N2 - Late preterm infants (34-37 weeks postmenstrual age at birth) are intermediate between less mature preterm infants and infants born at 38 weeks or more in regard to autonomic brain stem maturation. Ventilatory responses to CO(2) in preterm infants born at 33 to 36 week are significantly higher than in infants born at 29 to 32 weeks both at 3 to 4 and 10 to 14 days postnatal age, but do not differ from full-term reference levels. The ventilatory response to hypoxia in preterm infants is biphasic; initial transient hyperventilation is followed by a return to baseline and then a decrease below baseline. In infants born at 32 to 37 weeks, parasympathetic maturation appears significantly less than in full-term infants based on diminished increases in high frequency heart rate variability in quiet sleep, suggesting that late preterm infants are still more susceptible to bradycardia than full-term infants. Both the presence and severity of apnea of prematurity progressively decrease the higher the postmenstrual age. Late preterm infants, however, are still at risk, with prevalence rates as high as 10% compared with about 60% in infants born at <1500 g. The incidence of apparent life-threatening events is more common in preterm infants (8-10%) than full-term infants (1% or less). In the Collaborative Home Infant Monitoring Evaluation studies, the frequency of conventional and extreme events in near term infants is intermediate between preterm infants <34 weeks at birth and full-term infants. The relative risk for at least one extreme event in late preterm infants is increased (5.6 and 7.6, respectively, P < 0.008) compared with full-term infants and remains higher until 43 weeks postmenstrual age. The rate for Sudden Infant Death Syndrome in preterm infants born at 33 to 36 weeks is 1.37/1000 live births compared with 0.69 in infants born full term. Affected late preterm infants die at a older mean postmenstrual age compared with less mature infants (48 and 46 weeks, respectively), but die at a younger postmenstrual age than full-term infants (53 weeks, P < 0.05). SN - 0146-0005 UR - https://www.unboundmedicine.com/medline/citation/16731280/Ontogeny_of_autonomic_regulation_in_late_preterm_infants_born_at_34_37_weeks_postmenstrual_age_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0146-0005(06)00031-0 DB - PRIME DP - Unbound Medicine ER -