Long-Term Effects of Caffeine Therapy for Apnea of Prematurity

@article{citeulike:2650524, abstract = {Background Methylxanthine therapy is commonly used for apnea of prematurity but in the absence of adequate data on its efficacy and safety. It is uncertain whether methylxanthines have long-term effects on neurodevelopment and growth. Methods We randomly assigned 2006 infants with birth weights of 500 to 1250 g to receive either caffeine or placebo until therapy for apnea of prematurity was no longer needed. The primary outcome was a composite of death, cerebral palsy, cognitive delay (defined as a Mental Development Index score of <85 on the Bayley Scales of Infant Development), deafness, or blindness at a corrected age of 18 to 21 months. Results Of the 937 infants assigned to caffeine for whom adequate data on the primary outcome were available, 377 (40.2\%) died or survived with a neurodevelopmental disability, as compared with 431 of the 932 infants (46.2\%) assigned to placebo for whom adequate data on the primary outcome were available (odds ratio adjusted for center, 0.77; 95\% confidence interval [CI], 0.64 to 0.93; P=0.008). Treatment with caffeine as compared with placebo reduced the incidence of cerebral palsy (4.4\% vs. 7.3\%; adjusted odds ratio, 0.58; 95\% CI, 0.39 to 0.87; P=0.009) and of cognitive delay (33.8\% vs. 38.3\%; adjusted odds ratio, 0.81; 95\% CI, 0.66 to 0.99; P=0.04). The rates of death, deafness, and blindness and the mean percentiles for height, weight, and head circumference at follow-up did not differ significantly between the two groups. Conclusions Caffeine therapy for apnea of prematurity improves the rate of survival without neurodevelopmental disability at 18 to 21 months in infants with very low birth weight. (ClinicalTrials.gov number, NCT00182312 .) 10.1056/NEJMoa073679}, author = {Schmidt, Barbara and Roberts, Robin S. and Davis, Peter and Doyle, Lex W. and Barrington, Keith J. and Ohlsson, Arne and Solimano, Alfonso and Tin, Win and The}, citeulike-article-id = {2650524}, doi = {http://dx.doi.org/10.1056/NEJMoa073679}, journal = {N Engl J Med}, keywords = {caffein, neonate}, month = {November}, number = {19}, pages = {1893--1902}, posted-at = {2008-04-16 02:18:30}, priority = {2}, title = {Long-Term Effects of Caffeine Therapy for Apnea of Prematurity}, url = {http://dx.doi.org/10.1056/NEJMoa073679}, volume = {357}, year = {2007} }

TY - JOUR ID - citeulike:2650524 L3 - citeulike-article-id:2650524 TI - Long-Term Effects of Caffeine Therapy for Apnea of Prematurity JF - N Engl J Med VL - 357 IS - 19 SP - 1893 EP - 1902 N2 - Background Methylxanthine therapy is commonly used for apnea of prematurity but in the absence of adequate data on its efficacy and safety. It is uncertain whether methylxanthines have long-term effects on neurodevelopment and growth. Methods We randomly assigned 2006 infants with birth weights of 500 to 1250 g to receive either caffeine or placebo until therapy for apnea of prematurity was no longer needed. The primary outcome was a composite of death, cerebral palsy, cognitive delay (defined as a Mental Development Index score of <85 on the Bayley Scales of Infant Development), deafness, or blindness at a corrected age of 18 to 21 months. Results Of the 937 infants assigned to caffeine for whom adequate data on the primary outcome were available, 377 (40.2%) died or survived with a neurodevelopmental disability, as compared with 431 of the 932 infants (46.2%) assigned to placebo for whom adequate data on the primary outcome were available (odds ratio adjusted for center, 0.77; 95% confidence interval [CI], 0.64 to 0.93; P=0.008). Treatment with caffeine as compared with placebo reduced the incidence of cerebral palsy (4.4% vs. 7.3%; adjusted odds ratio, 0.58; 95% CI, 0.39 to 0.87; P=0.009) and of cognitive delay (33.8% vs. 38.3%; adjusted odds ratio, 0.81; 95% CI, 0.66 to 0.99; P=0.04). The rates of death, deafness, and blindness and the mean percentiles for height, weight, and head circumference at follow-up did not differ significantly between the two groups. Conclusions Caffeine therapy for apnea of prematurity improves the rate of survival without neurodevelopmental disability at 18 to 21 months in infants with very low birth weight. (ClinicalTrials.gov number, NCT00182312 .) 10.1056/NEJMoa073679 KW - caffein KW - neonate AU - Schmidt, Barbara AU - Roberts, Robin AU - Davis, Peter AU - Doyle, Lex AU - Barrington, Keith AU - Ohlsson, Arne AU - Solimano, Alfonso AU - Tin, Win AU - The PY - 2007/11/08/ UR - http://dx.doi.org/10.1056/NEJMoa073679 ER -