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Doxapram for apnoea of prematurity and neurodevelopmental outcomes at age 5-6 years

Ludovic Tréluyer1,2, Elodie Zana-Taieb2,3, Pierre-Henri Jarreau4,2

  • 1Sorbonne Paris-Nord, Inserm, INRAE, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, Université Paris Cité, Paris, France ludovic.treluyer@inserm.fr.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|January 16, 2024
PubMed

Insights

Doxapram treatment for premature infants did not show long-term neurodevelopmental issues. This study found no association between doxapram for apnea of prematurity and neurodevelopmental disabilities in children born very preterm.

Area of Science:

  • Neonatal Medicine
  • Developmental Pediatrics
  • Pharmacology

Background:

  • Apnea of prematurity (AOP) is common in infants born before 32 weeks' gestation.
  • Doxapram is a respiratory stimulant sometimes used to treat AOP.
  • Long-term neurodevelopmental effects of doxapram in this population require further investigation.

Purpose of the Study:

  • To evaluate the long-term neurodevelopmental impact of doxapram in preterm infants.
  • To assess outcomes at 5-6 years of age in children treated for AOP.

Main Methods:

  • Secondary analysis of the EPIPAGE-2 French national cohort.
  • Population-based cohort study including infants born before 32 weeks' gestation.
  • Neurodevelopmental assessments (cerebral palsy, DCD, IQ, behavior) at 5-6 years.
  • Propensity score matching (2:1) to control for treatment assignment bias.

Main Results:

  • Initial analysis showed a potential association between doxapram and neurodevelopmental disabilities (OR 1.43, p=0.02).
  • After propensity score matching, perinatal characteristics were similar between groups.
  • Matched analysis found no significant association between doxapram and neurodevelopmental disabilities (OR 1.09, p=0.63).

Conclusions:

  • Doxapram treatment for apnea of prematurity was not associated with neurodevelopmental disabilities in very preterm infants.
  • Findings suggest that doxapram does not negatively impact long-term neurodevelopmental outcomes in this cohort.
  • Further research may explore optimal AOP management strategies.
Abstract

Keywords:
Child DevelopmentNeonatology

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