Effect of diphtheria-tetanus-pertussis immunization on prolonged apnea or bradycardia in siblings of sudden infant death syndrome victims.

Abstract

To determine whether the incidence of apnea or bradycardia increased after the first diphtheria-tetanus-pertussis (DTP) immunization in 100 subsequent siblings of victims of sudden infant death syndrome, we examined data obtained from floppy disk recordings attached to apnea-bradycardia monitors for episodes of apnea lasting 15 seconds or longer and episodes of bradycardia lasting 10 seconds or longer. The data were divided into three periods: (1) 10 days before the first DTP immunization was received (pre-DTP period), (2) 10 days immediately after the DTP (DTP period), and (3) 10 days after the DTP period (post-DTP period). Seventeen infants had at least one episode of prolonged apnea or prolonged bradycardia either before or after the 30-day study period (eight before only, eight after only, and one before and after). None of the infants had episodes of apnea lasting 15 seconds or more or bradycardia lasting 10 seconds or more during the pre-DTP or DTP period. One episode of apnea, 16 seconds long, and one episode of bradycardia lasting 11 seconds occurred in the post-DTP period. These results failed to confirm the clinical impression that DTP immunizations are associated with an increased frequency and severity of prolonged apnea. They also place in question the utility of assessing an infant's response to a DTP immunization to determine continued risk of apnea and bradycardia before home monitoring is discontinued.