{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:34:03Z","timestamp":1770813243823,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T00:00:00Z","timestamp":1770768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>The criteria for Brief Resolved Unexplained Events (BRUE) are used to stratify the risk in infants presenting with apneic episodes. However, these criteria often classify a high proportion of infants as higher risk. This study aimed to investigate the etiology of apneic episodes, particularly those compatible with BRUE, and to assess whether age \u226460 days is associated with serious underlying conditions. We conducted a retrospective study of infants aged &amp;lt;1 year who presented with apnea as the chief complaint or had an ICD-10 code P28.4 (Other apnea of newborn) recorded between 2014 and 2018 at Sk\u00e5ne Pediatric University Hospital. The cohort was divided into a BRUE subgroup, which was further stratified into lower- and higher-risk groups based on current BRUE criteria, and additionally stratified without considering age as a higher-risk factor. Infants with an ICD diagnosis related to respiratory tract infection (RTI) or clinical signs of RTI were categorized into a separate RTI sub-cohort. A total of 340 infants were included. No specific diagnosis was identified in 253 (74.4%) cases, while 63 (18.5%) were diagnosed with viral RTIs. There were 9 (2.6%) cases with serious conditions during the first encounter, all of whom appeared unwell or had alarming signs at presentation excluding them from a BRUE diagnosis. The BRUE sub-cohort included 188 infants, of whom 143 (76.1%) were classified as higher risk using current criteria. When age \u226460 days was excluded as a risk factor, only 45 (23.9%) were classified as higher risk. None of the infants with serious diagnoses were misclassified as lower risk under the modified criteria. The RTI sub-cohort included 158 infants, with 111 (70.3%) hospitalized; 90 of these (81.1%) were discharged within two days. Serious underlying conditions and complicated clinical courses were rare among well-appearing infants aged under 1 year, with apneic episodes. Age \u226460 days did not appear to be associated with serious diagnoses in the BRUE sub-cohort. Well-appearing infants with RTI symptoms also had benign outcomes. These findings suggest that age may warrant re-evaluation as a risk factor in BRUE stratification, and that well-appearing infants with RTI symptoms may be appropriately classified as low risk.<\/jats:p>","DOI":"10.3389\/fped.2026.1731324","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T06:51:09Z","timestamp":1770792669000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Etiology of apneic episodes in infants aged &lt;1 year and validation of brief resolved unexplained events risk-stratification criteria without age as a risk factor"],"prefix":"10.3389","volume":"14","author":[{"given":"Sanna","family":"Hellstr\u00f6m Schmidt","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Lund, Lund University","place":["Lund, Sweden"]},{"name":"Department of Pediatrics, Sk\u00e5ne University Hospital","place":["Lund, 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