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Text
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URL Address
<a href="http://doi.org/10.1001/jama.2011.2024" target="_blank" rel="noreferrer">http://doi.org/10.1001/jama.2011.2024</a>
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Title
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Survival without disability to age 5 years after neonatal caffeine therapy for apnea of prematurity
Publisher
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Jama
Date
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2012
Subject
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Child; Female; Humans; infant; Male; Follow-Up Studies; Treatment Outcome; Survival Analysis; Odds Ratio; Child Development; Incidence; Preschool; infant; Newborn; Premature; Apnea/drug therapy; Blindness/epidemiology/etiology/prevention & control; Caffeine/adverse effects/therapeutic use; Central Nervous System Stimulants/adverse effects/therapeutic use; Cerebral Palsy/epidemiology; Cognition Disorders/epidemiology/etiology/prevention & control; Deafness/epidemiology/etiology/prevention & control; Developmental Disabilities/epidemiology/etiology/prevention & control; N2N; Very Low Birth Weight
Creator
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Schmidt B; Anderson PJ; Doyle LW; Dewey D; Grunau RE; Asztalos EV; Davis PG; Tin W; Moddemann D; Solimano A; Ohlsson A; Barrington KJ; Roberts RS; Trial Investigators Caffeine for Apnea of Prematurity (CAP)
Description
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CONTEXT: Very preterm infants are prone to apnea and have an increased risk of death or disability. Caffeine therapy for apnea of prematurity reduces the rates of cerebral palsy and cognitive delay at 18 months of age. OBJECTIVE: To determine whether neonatal caffeine therapy has lasting benefits or newly apparent risks at early school age. DESIGN, SETTING, AND PARTICIPANTS: Five-year follow-up from 2005 to 2011 in 31 of 35 academic hospitals in Canada, Australia, Europe, and Israel, where 1932 of 2006 participants (96.3%) had been enrolled in the randomized, placebo-controlled Caffeine for Apnea of Prematurity trial between 1999 and 2004. A total of 1640 children (84.9%) with birth weights of 500 to 1250 g had adequate data for the main outcome at 5 years. MAIN OUTCOME MEASURES: Combined outcome of death or survival to 5 years with 1 or more of motor impairment (defined as a Gross Motor Function Classification System level of 3 to 5), cognitive impairment (defined as a Full Scale IQ<70), behavior problems, poor general health, deafness, and blindness. RESULTS: The combined outcome of death or disability was not significantly different for the 833 children assigned to caffeine from that for the 807 children assigned to placebo (21.1% vs 24.8%; odds ratio adjusted for center, 0.82; 95% CI, 0.65-1.03; P = .09). The rates of death, motor impairment, behavior problems, poor general health, deafness, and blindness did not differ significantly between the 2 groups. The incidence of cognitive impairment was lower at 5 years than at 18 months and similar in the 2 groups (4.9% vs 5.1%; odds ratio adjusted for center, 0.97; 95% CI, 0.61-1.55; P = .89). CONCLUSION: Neonatal caffeine therapy was no longer associated with a significantly improved rate of survival without disability in children with very low birth weights who were assessed at 5 years.
Identifier
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<a href="http://doi.org/10.1001/jama.2011.2024" target="_blank" rel="noreferrer">10.1001/jama.2011.2024</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2012
Anderson PJ
Apnea/drug therapy
Asztalos EV
Backlog
Barrington KJ
Blindness/epidemiology/etiology/prevention & control
Caffeine/adverse effects/therapeutic use
Central Nervous System Stimulants/adverse effects/therapeutic use
Cerebral Palsy/epidemiology
Child
Child Development
Cognition Disorders/epidemiology/etiology/prevention & control
Davis PG
Deafness/epidemiology/etiology/prevention & control
Developmental Disabilities/epidemiology/etiology/prevention & control
Dewey D
Doyle LW
Female
Follow-up Studies
Grunau RE
Humans
Incidence
Infant
JAMA
Journal Article
Male
Moddemann D
N2N
Newborn
Odds Ratio
Ohlsson A
Premature
Preschool
Roberts RS
Schmidt B
Solimano A
Survival Analysis
Tin W
Treatment Outcome
Trial Investigators Caffeine for Apnea of Prematurity (CAP)
Very Low Birth Weight