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There is no evidence of a temporal relationship between acid-based GER and apnea in preterm infants. In addition, GER does not prolong apnea duration and does not exacerbate the resultant decrease in heart rate and SaO2.

ObjectiveTo characterize cardiorespiratory events in preterm infants following both acid and non-acid GER as detected by pH and multiple intraluminal impedance (MII).Study DesignTwelve hour overnight studies were performed in 71 preterm infants (gestational age 29.4±3.0 wks, birth weight 1319±496 gm). Apnea ≥10 seconds in duration, bradycardia ≤80 bpm and oxygen desaturation ≤85% that occurred within 30 seconds after the initiation of GER were classified as associated with GER.Result12,957 cardiorespiratory events and 4164 GER episodes were documented. Less than 3% of all cardiorespiratory events were preceded by GER constituting 3.4% of apnea, 2.8% of oxygen desaturation and 2.9% of bradycardia events. GER did not prolong cardiorespiratory event duration or increase severity. In contrast, GER was associated with a shorter duration of oxygen desaturation events (7.8±4.6 vs 6.3±5.6 sec, p<.05).ConclusionGER is rarely associated with cardiorespiratory events, and has no detrimental effect on cardiorespiratory event duration or severity.