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Benefits of caffeine treatment in premature infants persist into childhood
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The use of caffeine for the prevention of bronchopulmonary dysplasia and to shorten the duration of assisted ventilation in premature newborns effectively improves expiratory flow rates at age 11 years, according to a study published in the American Journal of Respiratory and Critical Care Medicine.
“Infants born very preterm — less than 32 weeks’ gestational age — or less than 1,500 g have worse expiratory air flow in childhood and adulthood than those born at term or of normal birth weight,” Lex W. Doyle, MD, professor of neonatal pediatrics at the Royal Women’s Hospital Melbourne and head of the Australian National Health and Medical Research Council’s Center of Research Excellence in Newborn Medicine, and colleagues wrote.
The researchers note that preterm infants who have bronchopulmonary dysplasia are known to have worse respiratory outcomes later in life than those who did not have the condition. Caffeine is regularly used to reduce bronchopulmonary dysplasia, but the researchers write that the effects of the treatment on respiratory health in later childhood is unknown.
To examine whether the use of caffeine in infanthood can improve respiratory outcomes in children at 11 years who were born weighing less than 1,251 g, the researchers conducted a randomized controlled trial in which the expiratory flow rates of children aged 11 years were measured at the Royal Women’s Hospital in Melbourne. The measurements were compliant with the standards set by the American Thoracic Society.
Parents then completed a survey requesting information about their child’s respiratory health, and the results were then compared with those who were administered a placebo.
Of the 142 children who were included in the study and had their expiratory flows measured, those in the caffeine group demonstrated better results by nearly 0.5 SD for most variables (mean z-score: –1.00 vs. –1.53; mean difference: 0.54, 95% CI 0.14,0.94, P = .008). Those in the caffeine group were also less likely to have measurements for forced vital capacity below the fifth percentile (11% vs. 28%; OR 0.31, 95% CI 0.12, 0.77, P = .012).
Differences between the placebo and caffeine group lessened once the researchers adjusted for bronchopulmonary dysplasia.
“Given the known benefits of caffeine in the newborn period in improving not only respiratory function but also neurological outcomes, particularly motor function in childhood, further placebo-controlled trials of neonatal caffeine versus placebo are unlikely to be repeated,” Doyle and colleagues wrote. — by Katherine Bortz
Disclosure: The researchers provide no relevant financial disclosures.
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