CARDIORESPIRATORY EVENTS DETECTED BY HOME MEMORY MONITORING AND ONE-YEAR NEURODEVELOPMENTAL OUTCOME CARL E. HUNT, MD, MICHAEL J. CORWIN, MD, TERRY BAIRD, MD, LARRY R. TINSLEY, MD, PAULA PALMER,PHD, RANGASAMY RAMANATHAN, MD, DAVID H. CROWELL,PHD, SUSAN SCHAFER, RNC, MS, RICHARD J. MARTIN, MD, DAVID HUFFORD, MD, MARK PEUCKER, BS, DEBRA E. WEESE-MAYER, MD, J EAN M. SILVESTRI, MD, MICHAEL R. NEUMAN,PHD, MD, AND J EAN CANTEY-KISER,PHD AND THE COLLABORATIVE HOME I NFANT MONITORING EVALUATION (CHIME) STUDY GROUP * Objective To determine if infants with cardiorespiratory events detected by home memory monitoring during early infancy have decreased neurodevelopmental performance. Study design Infants (n = 256) enrolled in the Collaborative Home Infant Monitoring Evaluation also completed the Bayley Scales of Infant Development II at 92 weeks’ postconceptional age. Infants were classified as having 0, 1 to 4, or 5+ cardiorespiratory events. Events were defined as apnea $20 seconds or heart rate <60 to 80 bpm or <50 to 60 bpm, for $5 to 15 seconds, depending on age. Results For term infants, having 0, 1 to 4, and 5+ cardiorespiratory events was associated with unadjusted mean Mental Developmental Index (MDI) values (±SD) of 103.6 (10.6), 104.2 (10.7), and 97.7 (10.9), respectively, and mean Psychomotor Developmental Index (PDI) values of 109.5 (16.6), 105.8 (16.5), and 100.2 (17.4). For preterm infants, having 0, 1 to 4, and 5+ cardiorespiratory events was associated with unadjusted mean MDI values of 100.4 (10.3), 96.8 (11.5), and 95.8 (10.6), respectively, and mean PDI values of 91.7 (19.2), 93.8 (15.5), and 94.4 (17.7). The adjusted difference in mean MDI scores with 5+ events compared with 0 events was 5.6 points lower in term infants (P = .03) and 4.9 points lower in preterm infants (P = .04). Conclusions Having 5+ conventional events is associated with lower adjusted mean differences in MDI in term and preterm infants. (J Pediatr 2004;145:465-71) T he Collaborative Home Infant Monitoring Evaluation (CHIME) included healthy term infants, infants presenting with a history of an apparent life-threatening event (ALTE), infants with a history of sudden infant death syndrome in a prior sibling, and preterm infants with a birth weight <1750 g and postconceptional age (PCA) at birth of #34 weeks. 1 Almost 7000 cardiorespiratory events exceeding conventional thresholds were observed during home memory monitoring, including 653 that also exceeded extreme thresholds (see METHODS for threshold definitions). None of these recorded events was directly associated with sudden and unexpected infant death. However, it is not known to what extent infants having events such as those observed in CHIME may be at increased risk for long-term neurodevelopmental impairment. The purpose of this study was to determine if cardiorespiratory events detected by the CHIME home memory monitor are associated with lower neurodevelopmental performance at 1 year of age. METHODS Subjects Infants were enrolled at five clinical sites (Chicago, Cleveland, Honolulu, Los Angeles, and Toledo) as part of the multicenter CHIME study. 1 CHIME was a study of *A complete list of the CHIME Study Group members and departmental and institutional affiliations can be found in the Appendix online (www.us. elsevierhealth.com/jpeds). Supported by NIH HD 29067, 29071, 28971, 29073, 29060, 20056, and 34625. Submitted for publication Dec 1, 2003; revision received Apr 28, 2004; accepted May 20, 2004. Reprint requests: Carl E. Hunt, MD, Director, National Center on Sleep Disorders Research, National Heart, Lung, and Blood Institute, 6705 Rock- ledge Dr, Ste 6022, Bethesda, MD 20892-7993. 0022-3476/$ - see front matter Copyright ª 2004 Elsevier Inc. All rights reserved. 10.1016/j.jpeds.2004.05.045 See editorial, p 430, and related article, p 458. ALTE Apparent life-threatening event AOP Apnea of prematurity BSID Bayley Scales of Infant Development 2 nd Edition CHIME Collaborative Home Infant Monitoring Evaluation MDI Mental Developmental Index PCA Postconceptional age PDI Psychomotor Developmental Index 465