LivingCaffeine therapy for premature babies

Caffeine therapy for premature babies

Although, at first glance, the caffeine-baby association may sound strange, the truth is that caffeine citrate is a compound widely used therapeutically to alleviate various problems associated with premature birth. Its best-known benefits include its role in the treatment of apnea and the prevention of conditions such as retinopathy and bronchopulmonary dysplasia.

The therapy is already widely applied around the world, and although it is known to be safe, it is still necessary to further refine the technique to know, for example, what are the optimal doses or when to start treatment. In 2014, a team of scientists from the University of Calgary (Canada) published a study that showed that starting caffeine therapy in the first two days of life had many advantages, since it reduced the risk of suffering from bronchopulmonary dysplasia and the time in which preterm infants needed ventilator assistance was shortened. What was not known was what long-term effects an early supply of caffeine might have on brain development.

Now, the same team of researchers has just published a study in the journal Pediatrics in which it follows more than two thousand children born before the 29th week of pregnancy (a normal pregnancy lasts about 40 weeks). The babies were divided into two groups: those who were treated in the first two days of life, and those who were started later.

“It was important to understand the long-term effects of caffeine and make sure that these babies not only survive, but also have quality of life in the future,” reflects Abhay Lodha, one of the authors of the work.

The results revealed that early caffeine treatment has no long-term effects on neurodevelopment. Moreover, the children in the first group obtained, in the follow-up tests carried out between 18 and 24 months, better cognitive scores and also had less possibilities of suffering from cerebral palsy and hearing impairment. “In the tests we analyzed the way these children had to solve simple problems or explore three-dimensional objects and toys,” explains Dianne Creighton, another of the researchers participating in the study. “We also evaluated whether the little ones were capable of understanding simple words or recognizing images, as well as their motor skills: climbing, crawling, balancing and coordinating, ” he adds.

How does caffeine work? According to Lodha, this compound could promote the growth of dendrites, those small branches of neurons that allow them to receive signals from others. “Caffeine can also improve lung stretching and expansion, cardiac output, and blood pressure in premature babies, improving oxygen delivery throughout the body and brain, reducing the duration of respiratory support, as well as the risk of chronic lung disease and lesions in the developing brain ”, concludes the researcher.

Caffeine therapy in Spain

In Spain, caffeine therapy in premature newborns is used with proven efficacy in certain situations, as David Delgado Chuecas, specialist in Gynecology and Obstetrics and Fetal Medicine, has indicated. “ In all neonates less than 30 weeks, and occasionally in some neonates between weeks 30 and 32 , the use of caffeine citrate is recommended from 24 hours before and during the 6 days following pulmonary extubation in case there is been necessary ”.

As for the doses, “they are usually adjusted weekly according to the weight of the newborn, and the administration is oral when the baby tolerates it well”, explains Delgado. “Variations in the dose are adjusted according to clinical criteria of potential toxicity, with which the appearance of adverse effects to the therapy is unlikely .” The expert reminds us that “treatment with caffeine for apneas of prematurity improves the survival rate without neurological alterations and improves the neurological prognosis in the newborn (specifically cerebral palsy and cognitive retardation)”.

Advisors: David Delgado Chuecas is a specialist in Gynecology and Obstetrics and Fetal Medicine and a member of Top Doctors.

Reference: Lodha et al. 2018. Early Caffeine Administration and Neurodevelopmental Outcomes in Preterm Infants. Pediatrics 142 (6).

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