January/February 2000, Volume 20, Issue 1, Pages 17 - 20

Original Article

Does Supine Positioning Increase Apnea, Bradycardia, and Desaturation in Preterm Infants? Darlene J. Keene, MD, John E. Wimmer Jr., MD & Oommen P. Mathew, MD Department of Pediatrics, East Carolina University School of Medicine, Greenville, NC.     Correspondence to: Oommen P. Mathew, MD, East Carolina University School of Medicine, Department of Pediatrics-Neonatology, 600 Moye Boulevard, Greenville, NC 27858-4354.

Abstract

OBJECTIVE: The purpose of this study was to determine the effects of prone and supine positioning on the cardiorespiratory stability of preterm infants with apnea and bradycardia. METHODS: A total of 22 preterm infants with symptomatic apnea and bradycardia (gestational age of 26.9 ± 1.8 weeks and birth weight of 865 ± 235 gm) were monitored for 24 hours (in four sequential 6-hour blocks) for apnea, bradycardia, and oxygen desaturation in alternating positions (prone or supine) following randomization. Postconceptional age at the time of study was 31.9 ± 3.0 weeks. Respiratory rate, heart rate, and transcutaneous oxygen saturation were continuously monitored. All episodes of apnea (10 seconds), bradycardia (<100 beats per minute), and oxygen desaturation (<90%) were recorded on an event monitor. Episodes of apnea, bradycardia, and oxygen desaturation were defined as clinically significant if the following criteria were met: apnea, 15 seconds; bradycardia, <90 beats per minute; and oxygen desaturation, <80%. All other recorded episodes were considered mild. The episodes were analyzed for statistical significance using the paired t-test. RESULTS: No significant differences (p > 0.05) in the incidence of clinically significant apnea, bradycardia, or desaturation between supine and prone positions were seen in these preterm infants. CONCLUSION: Our results suggest that the cardiorespiratory stability of preterm infants is not significantly compromised by supine positioning.

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