Neurobehavioral outcomes 11 years after neonatal caffeine therapy for apnea of prematurity

Ines M. Mürner-Lavanchy, Lex W. Doyle, Barbara Schmidt, Robin S. Roberts, Elizabeth V. Asztalos, Lorrie Costantini, Peter G. Davis, Deborah Dewey, Judy D'Ilario, Ruth E. Grunau, Diane Moddemann, Harvey Nelson, Arne Ohlsson, Alfonso Solimano, Win Tin, Peter J. Anderson, Caffeine for Apnea of Prematurity (CAP) Trial Group

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Abstract

BACKGROUND AND OBJECTIVES: Caffeine is effective in the treatment of apnea of prematurity. Although caffeine therapy has a benefit on gross motor skills in school-aged children, effects on neurobehavioral outcomes are not fully understood. We aimed to investigate effects of neonatal caffeine therapy in very low birth weight (500-1250 g) infants on neurobehavioral outcomes in 11-year-old participants of the Caffeine for Apnea of Prematurity trial. METHODS: Thirteen academic hospitals in Canada, Australia, Great Britain, and Sweden participated in this part of the 11-year follow-up of the double-blind, randomized, placebocontrolled trial. Measures of general intelligence, attention, executive function, visuomotor integration and perception, and behavior were obtained in up to 870 children. The effects of caffeine therapy were assessed by using regression models. RESULTS: Neurobehavioral outcomes were generally similar for both the caffeine and placebo group. The caffeine group performed better than the placebo group in fine motor coordination (mean difference [MD] = 2.9; 95% confidence interval [CI]: 0.7 to 5.1; P = .01), visuomotor integration (MD = 1.8; 95% CI: 0.0 to 3.7; P < .05), visual perception (MD = 2.0; 95% CI: 0.3 to 3.8; P = .02), and visuospatial organization (MD = 1.2; 95% CI: 0.4 to 2.0; P = .003). CONCLUSIONS: Neonatal caffeine therapy for apnea of prematurity improved visuomotor, visuoperceptual, and visuospatial abilities at age 11 years. General intelligence, attention, and behavior were not adversely affected by caffeine, which highlights the long-term safety of caffeine therapy for apnea of prematurity in very low birth weight neonates.

Original languageEnglish
Article numbere20174047
Number of pages11
JournalPediatrics
Volume141
Issue number5
DOIs
Publication statusPublished - 1 May 2018

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