Abstract
The incidence of sudden infant death syndrome has been found to be consistently higher in preterm and low birth weight infants than in infants born at term. Failure to arouse from sleep is one possible mechanism for sudden infant death syndrome. This study compared the arousal responses to nasal air-jet stimulation in a longitudinal study between groups of healthy preterm and term infants. Preterm infants (n = 9) were born at 31–35 wk gestation with normal birth weights for gestational age and studied on three occasions: a preterm study at 36 wk, at 2–3 wk post-term, and at 2–3 mo post-term. Term infants (n = 22) were born at 37–42 wk and were studied at 2–3 wk and 2–3 mo post-term. Arousal thresholds were determined in both active sleep (AS) and quiet sleep (QS). In preterm infants, there was no state-related difference in arousal thresholds at either the 36 wk or 2–3 wk study; however, at 2–3 mo, arousal threshold was significantly greater in QS than AS (p < 0.05). In contrast, in term infants, arousal thresholds were significantly elevated in QS compared with AS at both 2–3 wk and 2–3 mo (p < 0.001). Arousal thresholds in AS were not different between the two groups of infants, with both groups of infants remaining readily arousable. However, in QS at 2–3 mo, arousal thresholds were significantly lower in the preterm infants (p < 0.05). This study has demonstrated that arousability is altered by gestational and postnatal age. The lower arousability that characterizes QS in term infants regardless of age is not evident in preterm infants until 2–3 mo post-term age.
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Abbreviations
- SIDS:
-
sudden infant death syndrome
- QS:
-
quiet sleep
- AS:
-
active sleep
- HR:
-
heart rate
- EMG:
-
electromyogram
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Acknowledgements
The authors thank the staff of the Newborn Services and the Moorabbin Birth Centre of the Monash Medical Centre and the parents and infants who participated in this study. We also thank Associate Professor Adrian Walker and Professor Richard Harding for their comments on drafts of this manuscript.
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Supported by the National SIDS Council of Australia Ltd.
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Horne, R., Sly, D., Cranage, S. et al. Effects of Prematurity on Arousal from Sleep in the Newborn Infant. Pediatr Res 47, 468–474 (2000). https://doi.org/10.1203/00006450-200004000-00010
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DOI: https://doi.org/10.1203/00006450-200004000-00010
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