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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Reduction in developmental coordination disorder with neonatal caffeine therapy
Lex W Doyle1, Barbara Schmidt2, Peter J Anderson3
1Department of Obstetrics and Gynecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Victoria, Australia; Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
Insights
Neonatal caffeine therapy for apnea of prematurity was found to reduce the rate of developmental coordination disorder (DCD) at 5 years of age. This finding offers an additional benefit beyond preventing cerebral palsy.
Area of Science:
- Neonatal medicine
- Developmental pediatrics
- Neuroscience
Background:
- Developmental Coordination Disorder (DCD) affects motor skills and is more prevalent than cerebral palsy.
- Neonatal caffeine therapy is commonly used for apnea of prematurity.
Purpose of the Study:
- To investigate the impact of neonatal caffeine treatment on the incidence of DCD at five years of age.
Main Methods:
- Utilized data from the Caffeine for Apnea of Prematurity trial.
- Assessed 1433 children at 5 years for motor performance (MABC), cerebral palsy, and Full-Scale IQ.
- Defined DCD as MABC < 5th percentile in children with IQ > 69 and no cerebral palsy diagnosis.
Main Results:
- The rate of DCD was significantly lower in the caffeine group (11.3%) compared to the placebo group (15.2%).
- An adjusted odds ratio of 0.71 (95% CI, 0.52-0.97; P=.032) indicated a reduced risk of DCD with caffeine treatment.
Conclusions:
- Neonatal caffeine therapy for apnea of prematurity is associated with a reduced rate of DCD at 5 years.
- This suggests an important additional neurodevelopmental benefit of caffeine treatment in preterm infants.
Objective:
To determine the effect of neonatal caffeine treatment on rates of developmental coordination disorder (DCD).
Study Design:
Children in the Caffeine for Apnea of Prematurity trial were assessed for motor performance (Movement Assessment Battery for Children [MABC]), clinical signs of cerebral palsy, and Full-Scale IQ at 5 years of age by staff who were unaware of the children's treatment group. DCD was defined as MABC<5th percentile in children with a Full-Scale IQ>69 who did not have a diagnosis of cerebral palsy.
Results:
There were 1433 children with known MABC corrected-age percentile as well as known Full-Scale IQ at 5 years and cerebral palsy status, of whom 735 had been randomly assigned to caffeine and 698 to placebo therapy. The rate of DCD was lower in those treated with caffeine (11.3%) than in the placebo group (15.2%) (OR adjusted for center and baseline covariates, 0.71, 95% CI, 0.52-0.97; P=.032).
Conclusions:
Neonatal caffeine therapy for apnea of prematurity reduces the rate of DCD at 5 years of age. As more children have DCD than have cerebral palsy, this is an important additional benefit from neonatal caffeine treatment.
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