ABSTRACT
OBJECTIVE: To determine whether a significant relationship exists between the presence of apnea and the number of days it takes a premature infant to attain full oral feeding. DESIGN: A two-way analysis of variance factorial design (apnea x aminophylline) was used with infants grouped according to presence or absence of apnea and whether they were receiving aminophylline. SETTING: Neonatal intensive-care and step-down nurseries of a level III teaching hospital. PATIENTS/PARTICIPANTS: Eligibility criteria for this study included gestational age of 28-34 weeks, less than 48 hours of mechanical ventilation, and absence of congenital anomalies. Infants were classified into one of four groups: Group 1 (NN) consisted of infants who had no recorded apnea and were not receiving aminophylline (n = 27); group 2 (AA) consisted of infants receiving aminophylline who continued to experience apnea during the transition time to oral feeding, (n = 20); group 3 (NA) consisted of infants receiving aminophylline who did not experience apnea during the transition time to oral feeding (n = 12); and group 4 (AN) were infants who experienced some apnea but never received aminophylline (n = 6). All 65 enrolled subjects completed the study. PROCEDURES: Review of medical records and daily nursing notes to record apnea instances and oral feeding status for each 24-hour period. MAIN OUTCOME MEASURES: The number of days between the first attempted oral feeding and full oral feeding was recorded, as well as number of apnea instances occurring during the transition time. RESULTS: An analysis of variance procedure showed that groups who did not experience apnea had a significantly (F[1, 61] = 10.19, p < .01) shorter transition time (NN = 6.6 days, NA = 5.4 days) than groups who did (AA = 11.3 days, AN = 10.3 days). Apnea was found to be correlated strongly with transition time (R = .42, p < .001). A multiple linear regression forward selection procedure showed apnea to make the greatest contribution to variance in transition time in days with a partial R2 of .18 (p < .001). CONCLUSION: Apnea appears to be a factor that influences the length of time it takes a premature infant to begin receiving full oral feedings.
