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Published on: August 25, 2014
Methylxanthines and sensorineural outcome at 14 years in children < 1501 g birthweight
P G Davis1, L W Doyle, A L Rickards
1Department of Obstetrics and Gynaecology, University of Melbourne, Australia. p.davis@obgyn-rwh.unimelb.edu.au
Insights
Theophylline treatment in preterm infants was linked to increased cerebral palsy but also improved psychological scores by age 14. Long-term effects of this neonatal apnea therapy require further investigation.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Pharmacology
Background:
- Theophylline is a common treatment for apnea in preterm infants.
- Long-term outcomes of theophylline therapy in this population are not well understood.
Purpose of the Study:
- To investigate the association between theophylline therapy and outcomes at 14 years of age in preterm infants with birthweights under 1501g.
Main Methods:
- A cohort of 154 preterm infants (birthweight < 1501g) was studied.
- 130 survivors were assessed at 14 years for motor function, psychological scores, and growth.
- Exposure to theophylline was recorded.
Main Results:
- Theophylline exposure was associated with a significantly higher rate of cerebral palsy (13.0% vs 1.6%).
- This association remained significant after adjusting for confounding factors like cerebroventricular hemorrhage.
- Theophylline-exposed children showed higher psychological test scores, even after adjustment for confounders.
- No significant association was found between theophylline therapy and growth.
Conclusions:
- Neonatal theophylline therapy shows a dual effect at 14 years, with potential harm (cerebral palsy) and benefit (sensorineural function).
- Further research is needed to fully understand the long-term neurological consequences of theophylline treatment in preterm infants.
Objectives:
Methylxanthines, including theophylline, have been used extensively and successfully to treat apnoea in preterm infants. However, long-term consequences of such therapy are largely unknown. The aim of this study was to determine the relationship between theophylline therapy and outcome at 14 years of age in surviving preterm children of birthweight < 1501 g.
Methodology:
The subjects of this study were 154 consecutive survivors with birthweights < 1501 g born from 1 October 1980 to 31 March 1982; 130 (84.4%) were assessed at 14 years of age. Outcomes included motor function, psychological test scores, and growth.
Results:
Of the 130 children assessed, 69 (53.1%) had been exposed to theophylline; 13.0% had cerebral palsy, significantly higher than 1.6% in the 61 children not exposed to theophylline (P < 0.02). This difference remained statistically significant after adjusting for potential confounding variables including the presence of cerebroventricular haemorrhage. In contrast, after adjusting for known confounding variables, children who had received theophylline achieved higher psychological test scores. There was no association between theophylline therapy and growth.
Conclusions:
Theophylline therapy in the newborn period is associated with some evidence of harmful, but also helpful sensorineural effects at 14 years of age.
