Caffeine Improves Long-Term Neurodevelopment in Premature Infants

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Caffeine Improves Long-Term Neurodevelopment in Premature Infants

The prompt administration of caffeine to very premature infants is associated with improvement in their long-term neurodevelopment, researchers reported here on April 27 at the 2015 Annual Meeting of the Pediatric Academic Societies (PAS)
The prowess of caffeine as a neuroprotectant has been harnessed to lessen apnoea in premature infants. Use of the drug in very premature infants also appears to be beneficial in terms of lessening bronchopulmonary dysplasia and patent ductus arteriosus. However, the benefits of caffeine on long-term neurodevelopment are less clear.
For the current prospective study, Abhay K. Lodha, MD, University of Calgary, Calgary, Alberta, and colleagues explored the effect of caffeine therapy started within 2 days following the birth of very preterm neonates on their neurodevelopment at a correct age of 18 to 21 months.
The study involved 3,145 surviving neonates <29 weeks gestational age born in 27 hospitals nationwide in Canada between July 1, 2009 and December 31, 2011. Of these, 467 missed subsequent follow-ups and caffeine data was missing in 8. The remaining 2,670 neonates had been randomised to receive caffeine within 2 days of birth (early caffeine, n = 1941) or later than 2 days after birth (late caffeine, n = 729).
By 18 to 21 months corrected age, infants in both groups were similar in terms of the occurrence of bronchopulmonary dysplasia, patent ductus arteriosus, intraventricular haemorrhage, sepsis, and necrotizing enterocolitis.
Neurodevelopmental impairment was evident in 1,164 (60%) infants in the early caffeine group and in 474 (65%) of the late caffeine group (adjusted odds ratio = 1.0; 95% confidence interval, 0.8-1.3).
The early caffeine group showed lower incidences of definitive cerebral palsy (3.9% vs 7.8%), visual impairment (1.6% vs 2.7%), hearing impairment (6.8% vs 9.9%), and Bayley-III composite scores <85 in cognition (13.2% vs 17.5%), language (33.5% vs 38.3%), and motor composition (19.9% vs 25.5%).
“There is a significantly lower incidence of adverse neurodevelopmental outcome in newborns in the early caffeine group,” concluded Dr. Lodha.
The researchers hope that the information will spur at least the consideration of caffeine’s prowess in the neurodevelopment in very premature neonates, if not the adoption of the use of caffeine therapy early after birth in this at-risk population.
[Presentation title: Early Caffeine Administration and Long-Term Neurodevelopmental Outcomes in Premature Infants (<29 Weeks) at 18 to 24 Months Corrected Age (CA) in Canadian Neonatal Follow-Up Network (CNFUN). Abstract 3856.127]