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[Metabolic, hormonal and nutritional effects of long-term theophylline therapy in preterm infants: a case-control
F Colonna1, T Pahor, U de Vonderweid
1Centro di Neonatologia-Istituto per l'Infanzia Burlo Garofolo di Trieste, Italia.
Insights
Long-term theophylline treatment in preterm infants appears safe for growth and metabolism. However, lower hemoglobin levels were observed in treated infants, warranting further investigation into its effects on neonatal erythropoiesis.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Pediatric Endocrinology
Background:
- Theophylline is a common treatment for idiopathic apneas in preterm infants.
- Limited data exists on theophylline's impact on infant nutritional and hormonal status.
Purpose of the Study:
- To investigate the long-term effects of theophylline on metabolic and hormonal parameters in preterm infants.
- To assess the safety of theophylline regarding growth, metabolism, and organ function.
Main Methods:
- A case-control study compared 18 theophylline-treated preterm infants with 18 untreated controls.
- Evaluated 16 laboratory parameters including proteins, glucose, lipids, hormones, and glomerular function.
- Standardized measurements for growth velocity, body weight, and caloric/protein intake.
Main Results:
- No significant differences were found in growth velocity or most metabolic/hormonal parameters between groups.
- Theophylline-treated infants showed significantly lower hemoglobin levels (10.5 vs. 12.7 g/dL).
- No adverse effects on glucose, protein, lipid metabolism, or glomerular function were detected.
Conclusions:
- Long-term theophylline administration appears safe for preterm infants concerning growth, metabolism, and hormonal balance.
- Further research is necessary to understand theophylline's specific effects on neonatal erythropoiesis and hemoglobin levels.
Abstract:
Theophylline is widely used in preterm newborns for the prevention of idiopathic apnoeas, but few controlled studies have evaluated its effects on the nutritional and hormonal status of the infant. For this reason we have studied the effect of long term theophylline administration on 16 laboratory parameters concerning the metabolism of proteins, glucose, lipids, hormones and the glomerular function (blood: hemoglobin, glucose, albumin, prealbumin, urea nitrogen, creatinine, cholesterol, triglycerides, apolipoproteins A-I and B-100, IGF-I, IGFBP-3; urine: urea nitrogen, creatinine, C-peptide, GH). A case-control study was performed on 18 healthy preterm infants who were receiving oral theophylline for the prevention of idiopathic apnoeas. The mean duration of therapy at the moment of the balance study was 31 days (SD 12, range 12-51), the mean daily dose was 4.2 mg/kg (SD 1.0), the plasma range of theophylline concentration was 5 to 15 mg/l. As controls, 18 healthy preterm infants of comparable post-conceptional age, body weight and calories/protein intake at the moment of the study, were selected if they had been never treated with theophylline. No statistically significant differences were found between the two groups for the growth velocity or any of the parameters studied. The only notable exception was hemoglobin, which was significantly lower in theophylline treated infants (mean values 10.5 vs 12.7 g/dl, p 0.005 at t test). In synthesis, long term theophylline treatment in preterm infants seems to be safe from the point of view of growth, glucose, protein and lipid metabolism, hormones and glomerular function, but further studies are needed on the effects of theophylline on neonatal erythropoiesis.