{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T12:59:44Z","timestamp":1791118784463,"version":"4.1.0"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,11,1]]},"abstract":"<jats:p>Objective.\u2003Most neonatologists include an apnea-free period in the criteria for the discharge of preterm infants. However, the length of time one should wait after the cessation of apnea before sending an infant home without a monitor is debated. We undertook this study in an attempt to define a minimal and safe observation period between the time of the last apnea episode and discharge.<\/jats:p><jats:p>Methods.\u2003We reasoned that in infants with idiopathic apnea of prematurity, the intervals between days on which apnea occurs gradually increase until some point at which clinically significant apnea ceases. Therefore, knowledge about the intervals between days on which apnea occurred just before the last apnea would provide a reasonable estimate of the minimal safe observation interval between the last apnea and discharge. We reviewed the charts of 266 infants born in 1993 and 1994 at \u226432 weeks' gestational age or weighing \u22641500 g at birth from two institutions to determine the intervals between the day on which the last apnea occurred and the previous two days on which apnea occurred. One hundred seventy-five infants were excluded because they never experienced apnea, or data about the last apnea was missing, or they were on xanthines during the period encompassing the last 3 apnea days, or they weighed &amp;lt;1500 g or were &amp;lt;34 weeks' postmenstrual age at the time of the last apnea. Of the 91 remaining infants, gestational age at birth, birth weight, 1- and 5-minute Apgar scores, and discharge weight were not different between the two institutions. For each infant we determined the longest of the intervals between the 2 days on which apnea occurred previous to the day of the last apnea (MAXINT for maximum interval). The infants were then ordered by MAXINT and, starting at the longest MAXINT, the medical records of each infant were carefully examined for other conditions known to be associated with apnea (eg, recovering from anesthesia, sepsis, chronic lung disease, and so forth). The minimal safe observation period was then defined as the longest MAXINT in which there was at least 1 infant with no other explanation for the apnea other than prematurity.<\/jats:p><jats:p>Results.\u2003The median duration of the intervals between the 2 days on which apnea occurred previous to the day on which the last apnea occurred were 3.0 and 2.0 days and the median duration of the MAXINT was 4.0 days. On careful examination of the charts, it was determined that each of 13 infants with a MAXINT preceding the day on which the last apnea occurred of greater than 8 days had some other condition that might result in apnea, including residual lung disease, sepsis, surgery, and so forth. In contrast, among the group of infants with a MAXINT of \u22648 days, at least 1 infant at each MAXINT (eg, 1 to 8) had significant apnea with no other explanation other than prematurity.<\/jats:p><jats:p>Conclusions.\u2003We conclude that otherwise healthy preterm infants continue to have apneas separated by as many as 8 days before the last apnea before discharge. Conversely, infants with longer apnea intervals often have identifiable risk factors other than apnea of prematurity.<\/jats:p>","DOI":"10.1542\/peds.100.5.795","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:40:17Z","timestamp":1092440417000},"page":"795-801","source":"Crossref","is-referenced-by-count":109,"title":["Margin of Safety for Discharge After Apnea in Preterm Infants"],"prefix":"10.1542","volume":"100","author":[{"given":"Robert A.","family":"Darnall","sequence":"first","affiliation":[{"name":"From the Departments of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kattwinkel","sequence":"additional","affiliation":[{"name":"University of Virginia Medical Center, Charlottesville, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candace","family":"Nattie","sequence":"additional","affiliation":[{"name":"From the Departments of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; and the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Robinson","sequence":"additional","affiliation":[{"name":"University of Virginia Medical Center, Charlottesville, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1997,11,1]]},"reference":[{"key":"2021121006442054000_B1","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/S0022-3476(77)80691-4","article-title":"Apnea of prematurity. 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