Apnea of Prematurity: Current Practices and Future Directions

Abstract

Apnea of prematurity (AOP) is a developmental disorder affecting most infants born at less than 34 weeks’ gestational age. AOP is one of the most common diagnoses in the NICU, contributing substantially to prolonged hospitalization. Despite its frequent occurrence in premature neonates born at less than 37 weeks’ gestation, there is no common consensus on its definition, monitoring practices, and clinical relevance, leading to significant variation in practice. It is also not clear how and if repeated apneas, bradycardias, and hypoxemia are indeed detrimental to the developing neonate. This article reviews the definitions of AOP and the current standard of care for AOP, which includes positioning, positive pressure ventilation, and methylxanthine therapy. We also explore some novel therapies, as well as address controversies in initiating treatment, length of treatment, and guidelines for discharge.