9 3 4 Barrington, Finer, and Li The Journal of Pediatrics December 1996 11. Schwartz DL, So HB, Bungarz WR, et al. A case of life-threat- ening gastrointestinal hemorrhage in an infant with AIDS. J Pediatr Surg 1989;24:313-5. 12. Zupancic JAF, Pennie RA, Issenman R. Intussusception in a child with cytomegalovirus infection. Pediatr Infect Dis J 1994;13:548-9. 13. Tatum ET, Sun Pc, Cohn DL. Cytomegalovirus vasculitis and colon perforation in a patient with the acquired immunodefi- ciency syndrome. Pathology 1989;21:235-8. 14. Kram HB, Shoemaker WC. Intestinal perforation due to cyto- megalovirus in patients with AIDS. Dis Colon Rectum 1990; 33:1037-40. 15. De Riso AJ II, Kemeny MM, Totes RA, Oliver JM. Multiple jejunal perforations secondary to cytomegalovirus in a patient with acquired immune deficiency syndrome: case report and review. Dig Dis Sci 1989;34:623-9. 16. Burke G, Nichols L, Balogh K, et al. Perforation of the termi- nal ileum with cytomegalovirus vasculitis and Kaposi's sar- coma in a patient with acquired immunodeficiency syndrome. Surgery 1987;102:540-5. 17. Genta RM, Bleyzer I, Cate TR, Tandon AK, Yoffe B. In situ hybridization and immunohistochemical analysis of cytomeg- alovims-associated ileal perforation. Gastroenterology 1993; 104:1822-7. Predischarge respiratory recordings in very low birth weight newborn infants Keith J. Barrington, MB, ChB, MRCP(UK), FRCPC(C), Neil Finer, MD FRCP(C), a n d Dejuan Li, MD From the Perinatal Research Centre, University of Alberta, and the Division of Newborn Medicine, Royal Alexandra Hospital, Edmonton, Alberta, Canada Premise: There may be a relationship between undiagnosed, ongoing apnea oc- curring at discharge in infants of very low birth weight and sudden infant death syndrome. Objective: To describe patterns of apnea in former very low birth weight (<1251 gm) infants thought to be ready for hospital discharge, and to determine the re- lationship between apnea at discharge and later adverse events--in particular, apparent life-threatening events (ALTEs) and sudden infant death syndrome. Methods: One hundred eighty-seven infants had 24-hour (four-channel) record- ings scored for apnea (>12 seconds in duration) frequency, type, and duration. Infants were followed by telephone interview at 2, 4, and 6 months after discharge from the hospital. Results: Ninety-one percent of recordings displayed significant apnea, the majority of episodes of apnea were obstructive, and about half occurred during feedings. Infants had as many as 43 episodes in a 24-hour period, with a maxi- mum duration of 62 seconds. There was no relationship between severity of pre- discharge episodes of apnea and ALTEs. No infants died during follow-up. Conclusions: Predischarge multichannel recordings may identity infants with ap- nea that is not otherwise clinically apparent but do not predict the risk of an ALTE. (J Pediatr 1996; 129:934-40) It has previously been demonstrated that usual monitoring systems fail to detect much of the apnea occurring in the newborn infant) When objective recordings are used, many Submitted for publication June 29, 1995; accepted July 9, 1996. Reprint requests: Keith J. Barrington, MB,ChB, University of Cal- ifornia at San Diego Neonatal Perinatal Medicine 200 W. Arbor Dr., San Diego, CA 92103-8774. Copyright © 1996 by Mosby-Year Book, Inc. 0022-3476/96/$5.00 + 0 9/22/76354 formerly preterm infants who are considered to be ready to go home from neonatal intensive care units may still be hav- ing undiagnosed significant central apnea. 2 There is a clear I ALTE Apparent life-thxeatening event [ RSV Respiratory syncytial virus L VLBW Very low birth weight relationship between low birth weight and sudden infant death syndrome. 3' 4 Infants with a birth weight of less than