Presented at the Eastern Society for Pediatric Research Meeting, February 26-28, 1999, Atlantic City, NJ

NEONATAL MORBIDITY AND THE PNEUMOCARDIOGRAM (PCG)

Harel Rosen, Jeanne Curry, Debra Gutter, Mujahid Anwar, Mark Hiatt, Thomas Heygi. Division of Neonatology, UMDNJ-RWJ Medical School, St. Peters Medical Center, New Brunswick, NJ.

Bronchopulmonary dyplasia (BPD) but not intraventricular hemorrhage (IVH), common complications of prematurity influenced the PCG obtained at hospital discharge. The BPD group, composed of 29 infants (971.6 +/- 284.4g; 27.3 +/- 1.3wks) were significantly lighter and less mature that the 151 controls (2058 +/- 843g; 33.2 +/- 3.9wks p<.001) and were older at the time of study (postconceptional age: 38.0 +/- 1.3wks vs. 36.0 +/- 3.0wks), reflecting a longer length of stay. PCGs consisting of a combination of heart rate, respiratory rate, nasal air flow, and pulse oximetry were done on infants requiring home monitoring. There were statistically significant (p<0.01) differences identified in the incidence of prolonged apnea (69.0 vs. 41.1%), central apnea (65.5 vs. 32.5%), obstructive apnea (34.4 vs. 58.3%), mixed apnea (20.7 vs. 68.9%), and excessive periodic breathing (4.8 vs. 55.6%).

Comparing infants with (n=16) and without IVH (n=164), we found significant differences in birth weight (1183 +/- 328g vs. 1951 +/- 844g, p<.001), and in gestational age (27.5 +/- 1.5 wks vs. 32.7 +/- 4.1 wks, p=001). The postconceptional age at the time of study was similar (36.4 +/- 3.3 vs. 36.2 +/- 2.8 wks). There were no statistically significant differences identified in the incidence of central apnea (25.0 vs. 33.5%), obstructive apnea (68.8 vs. 58.5), mixed apnea (81.0 vs. 69.5%), and excessive periodic breathing (90.0 vs. 90.2%).

From these data we conclude that although GA at birth may be a confounder, BPD has a major influence on PCG testing at time of hospital discharge, especially since these infants were older at the time of study. Infants suffering from IVH showed no influence of the CNS injury on cardiorespiratory function.