Acid Gastroesophageal Reflux Disease and Apparent Life-Threatening Events: Simultaneous pH-metry and Cardiorespiratory Monitoring

Pediatr Neonatol. 2017 Feb;58(1):43-47. doi: 10.1016/j.pedneo.2015.12.005. Epub 2016 May 13.


Aim: To investigate the prevalence and the characteristics of gastroesophageal reflux disease (GERD) in infants with apparent life threatening events (ALTE).

Materials and methods: Infants with at least one episode of ALTE in absence of predisposing factors were included. All infants underwent a cardiorespiratory recording with simultaneous 24-hour pH-monitoring. Patients were divided into 3 groups according to the severity of GERD: A. Reflux Index (RI) <3%, B. RI = 3-7%, C. RI >7%. Monthly evaluations were performed and the anti-reflux therapy was maintained till normalization of monitoring and clinic.

Results: 41 infants were enrolled. GERD was found in 80% of patients (moderate in 54%, severe in 27%). A normalization of the cardiorespiratory tracks was recorded on average after 1 month for group A, 7 months for the group B and 9.5 months for group C. A significant difference was registered between group A and both group B and C (P < 0.0001), as well as between the group B and C (P < 0.05).

Conclusion: GERD influences significantly the time of normalization of the cardiorespiratory monitoring in infants with ALTE. GERD diagnosis and treatment are mandatory in these patients.

Keywords: apparent life threatening events; gastro-esophageal reflux disease; pH-metry.

MeSH terms

  • Cardiovascular Diseases / epidemiology*
  • Cohort Studies
  • Death
  • Female
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / diagnosis*
  • Gastroesophageal Reflux / mortality
  • Humans
  • Infant
  • Infant, Newborn
  • Male