Caffeine citrate for very preterm infants: Effects on development, temperament and behaviour

Gray, Peter H., Flenady, Vicki J., Charles, Bruce G., Steer, Peter A., on behalf of the Caffeine Collaborative Study Group, Shearman, A., Hegarty, J. and Rogers, Y. (2011) Caffeine citrate for very preterm infants: Effects on development, temperament and behaviour. Journal of Paediatrics and Child Health, 47 4: 167-172. doi:10.1111/j.1440-1754.2010.01943.x


Author Gray, Peter H.
Flenady, Vicki J.
Charles, Bruce G.
Steer, Peter A.
on behalf of the Caffeine Collaborative Study Group
Shearman, A.
Hegarty, J.
Rogers, Y.
Title Caffeine citrate for very preterm infants: Effects on development, temperament and behaviour
Journal name Journal of Paediatrics and Child Health   Check publisher's open access policy
ISSN 1034-4810
1440-1754
Publication date 2011-04
Sub-type Article (original research)
DOI 10.1111/j.1440-1754.2010.01943.x
Volume 47
Issue 4
Start page 167
End page 172
Total pages 6
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2012
Language eng
Formatted abstract Aim:
To compare two dosing regimens for caffeine citrate for neonates born less than 30 weeks gestation in terms of development, temperament and behaviour.

Methods:
A multi-centre, randomised, controlled trial design was undertaken. A total of 287 infants with apnoea of prematurity or in the peri-extubation period were randomised to receive one of two dosage regimens (20 vs. 5 mg/kg/day). The main outcomemeasure was cognitive development at 1 year of age on the Griffiths Mental Development Scales. Secondary outcomemeasures included neonatal morbidity, death and disability, temperament at 1 year and behaviour at 2 years of age.

Results:
Data on the primary outcome were available for 190 survivors at 12 months corrected for prematurity. A significantly greater mean general quotient was found in the high-dose group (mean (standard deviation), 98.0 (13.8) vs. 93.6 (16.5), P = 0.048). On omission of two infants for whom cognitive assessment was not possible because of disability while the mean general quotient remained higher for infants in the high-dose group, this was no longer statistically significant (P = 0.075). There was a non-significant trend for benefit in the high-dose caffeine group for death or major disability, 15.4% versus 24.2%; relative risk 0.75 (95% confidence interval 0.49–1.14). No differences in the mean values between the two groups were shown for temperament and behaviour.

Conclusions:
Caffeine citrate with a dosage regimen of 20 mg/kg/day did not result in adverse outcomes for development, temperament and behaviour. The borderline benefit in cognition with high-dose caffeine needs further investigation.
Keyword Behaviour
Caffeine
Development
Preterm
Temperament
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
School of Pharmacy Publications
 
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Created: Thu, 28 Jul 2011, 12:17:47 EST by Charna Kovacevic on behalf of School of Medicine