Background and aims Recommendations concerning the assessment of cardiorespiratory events during the first immunization with diphtheria-tetanus-pertussis-inactivated polio-Haemophilus influenzae type B (DTP-IPV-Hib) and Pneumococcal conjugate vaccine (PCV) of extremely preterm infants are discussed controversely. We examined the relationship between the immunization and cardiorespiratory events in preterm infants by using a mobile event monitor.
Methods We enrolled 84 extremely preterm infants [39 girls, 45 boys; gestational age (GA) < 28.0 weeks (range 23.5–27.6)]. Immunization took place in the last week before discharge (mean GA: 38 weeks). Recording monitors were used continuously 12 hours before and during 48 hours after immunization to document prolonged apnea and bradycardia.
Results The incidence of adverse cardiorespiratory events post-immunization (PI) was higher in the whole group with 40% of the infants having apneas >3 seconds longer than before immunization (BI), and more prolonged events of bradycardia. The longest apnea observed PI was 20 seconds. Mean PI desaturations were more pronounced (76% PI vs. 67% BI; p<0.05). Furthermore, during the first 24 hours PI the mean oxygen saturation was lower, and the mean heart rate was significantly higher. In 40% of the children the second immunization was performed under continuous cardiorespiratory monitoring.
Conclusions Preterm infants who received diphtheria-tetanus-pertussis-inactivated polio-Haemophilus influenzae type B and pneumococcal vaccine before discharge were more likely to temporarily experience prolonged apnea and bradycardia after immunization. Continuous mobile event monitoring of these infants was a helpful tool to detect clinically significant cardiorespiratory events.
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