Caffeine to help preemies breathe doesn't increase neurological risks: study

Giving premature infants caffeine therapy for breathing trouble doesn't increase the risk they will develop neurological problems and may, in fact, protect against cerebral palsy and cognitive delays, newly published data suggest.

"I think it is very exciting for clinicians, and I think also for parents," lead author Dr. Barbara Schmidt said of the findings, published Thursday in the New England Journal of Medicine.

"Because we now know that not only do we make the breathing a bit more regular but we don't need to worry about any downstream diverse effects that outweigh these short-term benefits."

The Canadian-led study reports on neurological followup at 18-to-21 months of 1,869 children from nine countries who were randomly assigned to either receive caffeine treatment or a placebo in the days aftertheir premature births.

The treatment is given to prevent or treat apnea, an irregular breathing pattern that can be caused by pre-term birth, or to ease the baby off of a mechanical ventilator when it is healthy enough to breathe on its own.

The researchers plan to continue to test the children for neurological problems to age five. And while experts, including Schmidt, cautioned that problems linked to the treatment could still become evident in the years ahead, they acknowledged that a number of key neurological conditions would be expected to have come to light in this first testing interval.

"It's very assuring because the outcomes at 18-to-22 months are fairly predictive of the longer-term outcomes," Dr. J.V. Aranda, a pioneer of caffeine therapy for preemies, said of the results.

The babies who received caffeine therapy had lower rates of cerebral palsy— 4.4 per cent — compared to 7.3 per cent in the children who got a placebo.

The study also foundfewer children with cognitive delays in the caffeine group — 33.8 per cent compared to 38.3 per cent in the placebo group.

"It's a great surprise to me. I would not have expected that result," Dr. Keith Tanswell, chief of neonatology at Toronto's Hospital for Sick Children, said of the cerebral palsy rates.

The authors of the study suggested that for every 16 preemies who receive caffeine therapy, one case of death or neurodevelopmental disability is avoided.