A causal relationship between gastro-esophageal reflux (GER) and apnea in preterm infants has been frequently hypothesized and is currently debated. The present study aims at reviewing the currently available scientific evidence, in order to clarify the role of GER on the occurrence of apnea and to help improving the clinical management of apneic preterm neonates. We performed a systematic literature search to identify all the clinical studies on preterm neonates that properly assessed the relationship between apnea and GER. Two-hundred and fifty-two papers, including 32 reviews and meta-analysis, were screened. Out of them, only 7 were included in the final analysis according to the selected criteria. Among them, 3 studies reported an increased frequency of apnea after reflux compared to reflux-free period and 4 denied a significant temporal relation. In conclusion, a minority of apneic events occurs soon after GER episodes. Whether this happens by chance or because of a causal relationship is still impossible to define. Based on the available data, empirical treatment with acid inhibitors is not recommended in neonates with apnea unless a proven temporal relation is shown by simultaneous esophageal pH-impedance and polysomnography or cardiorespiratory monitoring and in the absence of a clear clinical benefit.

Apnea in preterm neonates: what's the role of gastroesophageal reflux? A systematic review / Quitadamo, P.; Giorgio, V.; Zenzeri, L.; Baldassarre, M.; Cresi, F.; Borrelli, O.; Salvatore, S.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 52:7(2020), pp. 723-729. [10.1016/j.dld.2020.03.032]

Apnea in preterm neonates: what's the role of gastroesophageal reflux? A systematic review

Zenzeri L.;Borrelli O.;
2020

Abstract

A causal relationship between gastro-esophageal reflux (GER) and apnea in preterm infants has been frequently hypothesized and is currently debated. The present study aims at reviewing the currently available scientific evidence, in order to clarify the role of GER on the occurrence of apnea and to help improving the clinical management of apneic preterm neonates. We performed a systematic literature search to identify all the clinical studies on preterm neonates that properly assessed the relationship between apnea and GER. Two-hundred and fifty-two papers, including 32 reviews and meta-analysis, were screened. Out of them, only 7 were included in the final analysis according to the selected criteria. Among them, 3 studies reported an increased frequency of apnea after reflux compared to reflux-free period and 4 denied a significant temporal relation. In conclusion, a minority of apneic events occurs soon after GER episodes. Whether this happens by chance or because of a causal relationship is still impossible to define. Based on the available data, empirical treatment with acid inhibitors is not recommended in neonates with apnea unless a proven temporal relation is shown by simultaneous esophageal pH-impedance and polysomnography or cardiorespiratory monitoring and in the absence of a clear clinical benefit.
2020
apnea of prematurity; gastroesophageal reflux; preterm neonates
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
Apnea in preterm neonates: what's the role of gastroesophageal reflux? A systematic review / Quitadamo, P.; Giorgio, V.; Zenzeri, L.; Baldassarre, M.; Cresi, F.; Borrelli, O.; Salvatore, S.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 52:7(2020), pp. 723-729. [10.1016/j.dld.2020.03.032]
File allegati a questo prodotto
File Dimensione Formato  
11 Apnea in preterm neonates whats the role of gastroesophageal.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 408.37 kB
Formato Adobe PDF
408.37 kB Adobe PDF   Contatta l'autore
Quitadamo_Apnea_2020.pdf

solo gestori archivio

Note: review
Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 428.54 kB
Formato Adobe PDF
428.54 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1703562
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 4
social impact