Abstract 1492

Objective: Bradycardia and pathologic apnea in premature infants pose a risk of infant morbidity, delay hospital discharges, and contribute to parental anxiety. Our objective was to determine whether a documented event monitor (DEM) recording is useful in screening healthy preterm infants for pathologic apnea and bradycardia at the time of discharge. Methods: We reviewed 246 DEM recordings for preterm infants under 36 weeks corrected gestational age (CGA) prior to their discharge. Infants were discharged on DEM and received telephone follow-up for 6 months or until monitor no pathologic events were noted for 6 to 8 weeks. Sixteen infants were excluded due to non-compliance with the monitor. Abnormal events were defined as apnea greater than 20 seconds, apnea less than 20 seconds with bradycardia (<80 beats per minute), and isolated bradycardia. Results: Mean gestational age (GA) was 32 ± 0.2 weeks SEM. Mean CGA at time of study and hospital discharge was 34.6 ± 0.1 weeks SEM. (Table) The sensitivity, specificity, and positive predictive value of the initial study compared with follow-up at age 1 to 2 months for pathologic events are 50.5%, 74.8%, and 63.5%, respectively. CGA at time of last abnormal event was 37.2 ± 0.5 weeks if initial DEM was normal and 40.6 ± 0.8 weeks if initial DEM was abnormal (p<0.01). 10.5% of infants with initial abnormal DEM had untoward outcome (5 ALTE, 1 SIDS, 3 other hospitalization); 4.8% with initial normal DEM (2 ALTE, 5 other hospitalizations). The sensitivity, specificity, and positive predictive value of the initial DEM for untoward outcome are 56.0%, 35.5%, and 10.6%, respectively.

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