Pattern and determinants of newborn apnea in an under-resourced Nigerian setting

Objective: To determine the prevalence, distribution and determinants of newborn apnea in a resource-constrained setting. Design: Retrospective study. Materials and Methods: Newborn babies who had apnea during hospitalization between January and December 2008 were studied. The sex, age and body weight, clinical conditions, etiologies of apnea and outcome were recorded. Babies with and without apnea were compared using bivariate and multivariable analysis. Results: Out of 402 babies seen during the review, 78 (19.4) had apnea. They comprised 59 preterm and 19 term babies. Forty (51.3) had apnea at the point of admission while the remaining 38 (48.7) developed apnea after a mean interval of 118.5 101.1 hours. Thirty-seven percent of preterms had idiopathic apnea. Etiologies included respiratory distress (50.0), hypothermia (42.3), and asphyxia (28.2). Multivariate analysis showed that weight < 2.5kg, hypothermia, referred status and presence of respiratory distress were determinants of apnea. Case fatality rate was 82.2 among apneic babies. Conclusion: Apnea occurred commonly in this population of babies. Stringent efforts like ventilator supports for babies in respiratory distress, better perinatal care including thermoregulation are required to reduce the occurrence of the major risk factors for newborn apnea. The identified determinants can be used to draw up effective preventive measures in resource-poor settings.