Neurobehavioral Outcomes 11 Years After Neonatal Caffeine Therapy for Apnea of Prematurity

Area of Science:

• Neonatal medicine
• Developmental pediatrics
• Pharmacology

Background:

• Caffeine is a standard treatment for apnea of prematurity.
• While beneficial for gross motor skills, its long-term neurobehavioral effects require further investigation.
• This study focuses on very low birth weight infants.

Purpose of the Study:

• To assess the neurobehavioral outcomes at age 11 in very low birth weight infants who received neonatal caffeine therapy for apnea of prematurity.
• To evaluate the long-term effects of caffeine on cognitive, perceptual, and behavioral functions.

Main Methods:

• An 11-year follow-up of a double-blind, randomized, placebo-controlled trial involving 870 participants.
• Neurobehavioral assessments included general intelligence, attention, executive function, visuomotor integration, perception, and behavior.
• Statistical analysis using regression models to compare caffeine and placebo groups.

Main Results:

• The caffeine group showed significant improvements in fine motor coordination, visuomotor integration, visual perception, and visuospatial organization compared to the placebo group.
• No significant adverse effects were observed in general intelligence, attention, or behavior.
• Specific mean differences and confidence intervals highlight the magnitude of improvements in visual-spatial and motor skills.

Conclusions:

• Neonatal caffeine therapy for apnea of prematurity positively impacts visuomotor, visuoperceptual, and visuospatial abilities by age 11.
• The therapy demonstrates long-term safety, with no detrimental effects on cognitive or behavioral development.
• Caffeine therapy is a safe and effective intervention for very low birth weight neonates with apnea of prematurity.