Karinna L Fyfe1, Stephanie R Yiallourou1, Flora Y Wong2, Alexsandria Odoi3, Adrian M Walker3, Rosemary S C Horne4. 1. The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia; and. 2. The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia; and Monash Newborn, Monash Medical Centre, Melbourne, Australia. 3. The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; 4. The Ritchie Centre, Monash Institute of Medical Research and Prince Henry's Institute and Monash University, Melbourne, Australia; Department of Paediatrics, Monash University, Melbourne, Australia; and rosemary.horne@monash.edu.
Abstract
BACKGROUND AND OBJECTIVE: Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. METHODS: Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. RESULTS: In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P < .05). Notably, TOI was significantly lower in preterm compared with term infants at 2 to 4 weeks, in both positions (P < .05), and at 2 to 3 months when prone (P < .001), in both sleep states. MAP was also lower in preterm infants in the prone position at 2 to 3 months (P < .01). CONCLUSIONS: Cerebral oxygenation is reduced in the prone position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk.
BACKGROUND AND OBJECTIVE: Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. METHODS: Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. RESULTS: In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P < .05). Notably, TOI was significantly lower in preterm compared with term infants at 2 to 4 weeks, in both positions (P < .05), and at 2 to 3 months when prone (P < .001), in both sleep states. MAP was also lower in preterm infants in the prone position at 2 to 3 months (P < .01). CONCLUSIONS: Cerebral oxygenation is reduced in the prone position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk.
Authors: Karinna L Fyfe; Alexsandria Odoi; Stephanie R Yiallourou; Flora Y Wong; Adrian M Walker; Rosemary S C Horne Journal: Sleep Date: 2015-09-01 Impact factor: 5.849
Authors: Karinna L Fyfe; Stephanie R Yiallourou; Flora Y Wong; Alexsandria Odoi; Adrian M Walker; Rosemary S C Horne Journal: Sleep Date: 2015-10-01 Impact factor: 5.849
Authors: Rosemary S C Horne; Karinna L Fyfe; Alexsandria Odoi; Anjalee Athukoralage; Stephanie R Yiallourou; Flora Y Wong Journal: Pediatr Res Date: 2015-10-21 Impact factor: 3.756
Authors: Rosemary S C Horne; Sunjuri Sun; Stephanie R Yiallourou; Karinna L Fyfe; Alexsandria Odoi; Flora Y Wong Journal: J Physiol Date: 2018-04-11 Impact factor: 5.182
Authors: Kelsee L Shepherd; Flora Y Wong; Alexsandria Odoi; Emma Yeomans; Rosemary S C Horne; Stephanie R Yiallourou Journal: Pediatr Res Date: 2020-11-10 Impact factor: 3.756