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Definitions and monitoring methods for apnea in preterm infants: a scoping review

Pediatric Research (2025)Cite this article

A Correction to this article was published on 03 December 2025

This article has been updated

Abstract

Background

Despite the ubiquity of apnea among preterm infants, optimal definitions and monitoring practices remain unknown. This scoping review aims to describe the clinical methods used to monitor apnea in preterm infants and apnea definitions employed across the neonatal literature.

Methods

A search was performed in Cochrane Library, EMBASE, MEDLINE, and Web of Science for studies published in the last 25 years employing monitoring devices or algorithms for the purpose of identifying apneas in premature infants. Data surrounding participant information, devices employed, and apnea definitions were extracted.

Results

Across 176 included studies, 12 different devices were used to monitor breathing efforts and 7 devices to monitor respiratory airflow with the aim of capturing apneas. Methods for monitoring airflow remain limited in sensitivity and feasibility. Of 164 apnea definitions extracted from the studies, 110 (67%) consisted only of a minimum duration of the respiratory pause, while 54 (33%) additionally cited the presence of bradycardia and/or oxygen desaturation.

Conclusion

Significant variability exists in the methods used to detect apneas and the definitions employed in the current literature. Enhanced tools for monitoring apneas and standardized guidelines for defining apneas in preterm infants are needed.

Impact

  • This scoping review offers a comprehensive overview of the methods used to detect apneas in preterm infants, as well as the definitions of apnea employed in neonatal research.

  • The marked variability in apnea monitoring practices and definitions underscores the pressing need for standardization across clinical and research settings.

  • Advancing standardized approaches may require targeted research efforts leveraging multimodal and longitudinal monitoring to better capture the complexity of apnea in preterm infants.

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Fig. 1
Fig. 2: Devices employed to monitor apneas in preterm infants.
Fig. 3: Criteria used to define apnea across included studies.

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Data availability

All relevant data are included in the supplementary files.

Change history

  • 27 November 2025

    The original online version of this article was revised: In the sentence beginning 'Across 163 included studies,...' in this article, the value '163' should have read '176'.

  • 03 December 2025

    A Correction to this paper has been published: https://doi.org/10.1038/s41390-025-04678-7

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Acknowledgements

Thank you to Amy Bergeron for assisting in the synthesis and translation of a search strategy for the literature search. Preliminary analyses for this review have been presented at the Pediatric Academic Societies Meeting in 2023. This work was also made possible by a doctoral award granted by the Regroupement en IA soins aigus pour l’enfant of the Centre hospitalier universitaire de Saint-Justine.

Funding

Wissam Shalish was supported through a clinician-scientist Junior 1 award by the Fonds de Recherche du Québec – Santé and the Montreal Children’s Hospital Foundation.

Author information

Authors and Affiliations

  1. Department of Medicine, Division of Clinical and Translational Research, McGill University, Montreal, QC, Canada

    Emily Jeanne & Eva Sénéchal

  2. McGill University Health Center - Research Institute, McGill University, Montreal, QC, Canada

    Shasha Lv & Lydia Tao

  3. Department of Pediatrics, Division of Neonatology, Montreal Children’s Hospital, McGill University Health Center, Montreal, QC, Canada

    Tugba Alarcon Martinez, Guilherme Sant’Anna & Wissam Shalish

  4. Center for Autonomic Medicine in Pediatrics, Department of Pediatrics, Ann & Robert H Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Debra E. Weese-Mayer

  5. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Debra E. Weese-Mayer

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Contributions

W.S. and E.J. contributed to the conceptualization and design. E.J., E.S., S.L., T.A.M., and L.T. contributed to the acquisition of data. E.J. contributed to the analysis of data, interpretation of data, and drafting of the manuscript. W.S., G.S., and D.W.M. revised the manuscript. All authors approved the final manuscript as submitted.

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Correspondence to Wissam Shalish.

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The original online version of this article was revised: In the sentence beginning 'Across 163 included studies,...' in this article, the value '163' should have read '176'.

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Jeanne, E., Lv, S., Sénéchal, E. et al. Definitions and monitoring methods for apnea in preterm infants: a scoping review. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04571-3

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