Am J Perinatol 2018; 35(S 01): S1-S26
DOI: 10.1055/s-0038-1647088
Abstracts
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Early High-Dose Caffeine Citrate: Neonatal and Neurodevelopmental Outcomes

P. H. Gray
1   Newborn Services, Mater Mothers' Hospital, South Brisbane, Queensland, Australia
,
A. Molnar
1   Newborn Services, Mater Mothers' Hospital, South Brisbane, Queensland, Australia
,
B. Firman
1   Newborn Services, Mater Mothers' Hospital, South Brisbane, Queensland, Australia
› Author Affiliations
Further Information

Publication History

Publication Date:
27 April 2018 (online)

 
 

    Introduction: Early high-dose caffeine has been reported to be beneficial. However, a small randomized clinical trial found a higher incidence of cerebellar hemorrhage (CBH), though there was no effect on cognitive outcomes. The aim of this study was to assess high-dose caffeine citrate compared with standard dose for very preterm infants in terms of neonatal morbidities and neurodevelopmental outcomes at 2 years.

    Materials and Methods: Infants of  < 28 weeks’ gestation who received a loading dose of caffeine within the first 36 hours of life from 2011 to 2013 were included in the study. Infants in the high-dose group who received a median dose of 80 mg/kg were compared with infants in the standard dose group receiving a median dose of 20 mg/kg. Neonatal outcomes including results of cranial ultrasound (CUS) were compared. The infants were followed up at 2 years of age and had a neurological assessment, the Bayley Scales of Infant and Toddler Development, 3rd Edition and the Neurosensory Motor Developmental Assessment.

    Results: There were 58 infants in the high-dose group and 60 infants in the standard-dose group. Of them, 86 infants in the high-dose group and 42 infants in the standard-dose group completed the study and could be assessed at 2 years. The incidence of CBH detected by CUS was low: 4 (2.5%) in the high dose and 1 (1.7%) in the standard dose groups, with no difference in the incidence of IVH. The mean cognitive score on the Bayley for the high-dose group was 97.4 compared with 91.9 for the standard dose group (p = 0.062). There were no differences in the language or motor scores, the NSMDA results, or the incidence of cerebral palsy between the groups.

    Conclusion: High loading dose caffeine for infants  < 28 weeks gestation was not associated with adverse outcomes in this single-center study

    Keywords: extreme prematurity, caffeine citrate, cranial ultrasound, neurodevelopmental follow-up


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    No conflict of interest has been declared by the author(s).