No Long-Term Benefit of Caffeine for Apnea in Preemies

HealthDay News—Neonatal caffeine therapy for apnea of prematurity is no longer associated with increased survival without disability when assessed at five-year follow-up, according to a study published in the Jan. 18 issue of the Journal of the American Medical Association.

Barbara Schmidt, MD, from McMaster University in Canada, and colleagues investigated whether neonatal caffeine therapy had lasting benefits or new risks at early school age. Follow-up at five years was carried out for 1,640 children with birth weights of 500g–1,250g with adequate data, who had been enrolled in the randomized, placebo-controlled, Caffeine for Apnea of Prematurity trial. The main outcome measure was a combined outcome of death or survival to five years with disability (including one or more of the following: motor impairment, cognitive impairment, behavior problems, poor general health, deafness, or blindness).

The investigators found that there was no significant difference in the combined outcome of death or disability for the caffeine and placebo groups (21.1% and 24.8%, respectively; center-adjusted odds ratio [OR], 0.82; 95% CI, 0.65–1.03; P=0.09). There was no difference between the groups for rates of death, motor impairment, behavior issues, poor general health, deafness, or blindness. The incidence of cognitive impairment was lower at 5 years of age than at 18 months, and similar between the groups (4.9% and 5.1%, respectively; center-adjusted OR, 0.97; 95% CI, 0.61–1.55; P=0.89).

“This five-year follow-up study of participants in the international Caffeine for Apnea of Prematurity trial showed that the benefits of neonatal caffeine therapy on the rate of survival without disability at 18 months were attenuated during child development,” the authors write.

Several authors disclosed financial ties to Chiesi Pharmaceuticals, which manufactures caffeine citrate.

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