Document Detail


Survival without disability to age 5 years after neonatal caffeine therapy for apnea of prematurity.
MedLine Citation:
PMID:  22253394     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
CONTEXT: Very preterm infants are prone to apnea and have an increased risk of death or disability. Caffeine therapy for apnea of prematurity reduces the rates of cerebral palsy and cognitive delay at 18 months of age.
OBJECTIVE: To determine whether neonatal caffeine therapy has lasting benefits or newly apparent risks at early school age.
DESIGN, SETTING, AND PARTICIPANTS: Five-year follow-up from 2005 to 2011 in 31 of 35 academic hospitals in Canada, Australia, Europe, and Israel, where 1932 of 2006 participants (96.3%) had been enrolled in the randomized, placebo-controlled Caffeine for Apnea of Prematurity trial between 1999 and 2004. A total of 1640 children (84.9%) with birth weights of 500 to 1250 g had adequate data for the main outcome at 5 years.
MAIN OUTCOME MEASURES: Combined outcome of death or survival to 5 years with 1 or more of motor impairment (defined as a Gross Motor Function Classification System level of 3 to 5), cognitive impairment (defined as a Full Scale IQ<70), behavior problems, poor general health, deafness, and blindness.
RESULTS: The combined outcome of death or disability was not significantly different for the 833 children assigned to caffeine from that for the 807 children assigned to placebo (21.1% vs 24.8%; odds ratio adjusted for center, 0.82; 95% CI, 0.65-1.03; P = .09). The rates of death, motor impairment, behavior problems, poor general health, deafness, and blindness did not differ significantly between the 2 groups. The incidence of cognitive impairment was lower at 5 years than at 18 months and similar in the 2 groups (4.9% vs 5.1%; odds ratio adjusted for center, 0.97; 95% CI, 0.61-1.55; P = .89).
CONCLUSION: Neonatal caffeine therapy was no longer associated with a significantly improved rate of survival without disability in children with very low birth weights who were assessed at 5 years.
Authors:
Barbara Schmidt; Peter J Anderson; Lex W Doyle; Deborah Dewey; Ruth E Grunau; Elizabeth V Asztalos; Peter G Davis; Win Tin; Diane Moddemann; Alfonso Solimano; Arne Ohlsson; Keith J Barrington; Robin S Roberts;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  307     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  275-82     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada. schmidt@mcmaster.ca
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MeSH Terms
Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
MCT 13288//Canadian Institutes of Health Research
Investigator
Investigator/Affiliation:
Barbara Schmidt / ; Judy D'Ilario / ; Janice Cairnie / ; Joanne Dix / ; Beth Adams / ; Erin Warriner / ; Mee-Hai Marie Kim / ; Peter Anderson / ; Peter Davis / ; Lex Doyle / ; Brenda Argus / ; Kate Callanan / ; Noni Davis / ; Julianne Duff / ; Marion McDonald / ; Elizabeth Asztalos / ; Denise Hohn / ; Maralyn Lacy / ; Ross Haslam / ; Christopher Barnett / ; Louise Goodchild / ; Rosslyn Lontis / ; Simon Fraser / ; Julie Keng / ; Kerryn Saunders / ; Gillian Opie / ; Elaine Kelly / ; Heather Woods / ; Emma Marchant / ; Anne-Marie Turner / ; Noni Davis / ; Emma Magrath / ; Amanda Williamson / ; Aida Bairam / ; Sylvie Bélanger / ; Annie Fraser / ; Brigitte Lemyre / ; Jane Frank / ; Alfonso Solimano / ; Anne Synnes / ; Ruth E Grunau / ; Philippa Hubber-Richard / ; Marilyn Rogers / ; Margot Mackay / ; Julianne Petrie-Thomas / ; Arsalan Butt / ; Aleid van Wassenaer / ; Debbie Nuytemans / ; Bregje Houtzager / ; Loekie van Sonderen / ; Rivka Regev / ; Netter Itzchack / ; Shmuel Arnon / ; Adiba Chalaf / ; Arne Ohlsson / ; Karel O'Brien / ; Anne-Marie Hamilton / ; May Lee Chan / ; Koravangattu Sankaran / ; Sheila Morgan / ; Pat Proctor / ; Agneta Golan / ; Esther Goldsch-Lerman / ; Graham Reynolds / ; Barbara Dromgool / ; Sandra Meskell / ; Vanessa Parr / ; Catherine Maher / ; Margaret Broom / ; Zsuzsoka Kecskes / ; Cathy Ringland / ; Douglas McMillan / ; Debbie Schaab / ; Elizabeth Spellen / ; Reginald S Sauve / ; Heather Christianson / ; Deborah Anseeuw-Deeks / ; Dianne Creighton / ; Jennifer Heath / ; Ruben Alvaro / ; Aaron Chiu / ; Ceceile Porter / ; Gloria Turner / ; Diane Moddemann / ; Naomi Granke / ; Karen Penner / ; Jane Bow / ; Antonius Mulder / ; Renske Wassenberg / ; Markus van der Hoeven / ; Maxine Clarke / ; Judy Parfitt / ; Kevin Parker / ; Chukwuma Nwaesei / ; Heather Ryan / ; Cory Saunders / ; Andreas Schulze / ; Inga Wermuth / ; Anne Hilgendorff / ; Andreas W Flemmer / ; Eric Herlenius / ; Lena Legnevall / ; Hugo Lagercrantz / ; Derek Matthew / ; Wendy Amos / ; Suresh Tulsiani / ; Cherrie Tan-Dy / ; Marilyn Turner / ; Constance Phelan / ; Eric Shinwell / ; Michael Levine / ; Ada Juster-Reicher / ; May Khairy / ; Patricia Grier / ; Julie Vachon / ; Larissa Perepolkin / ; Keith J Barrington / ; Sunil Sinha / ; Win Tin / ; Susan Fritz / ; Herve Walti / ; Diane Royer / ; Henry Halliday / ; David Millar / ; Anne Berry / ; Clifford Mayes / ; Christopher McCusker / ; Olivia McLaughlin / ; Hubert Fahnenstich / ; Bettina Tillmann / ; Peter Weber / ; Unni Wariyar / ; Nicholas Embleton / ; Ravi Swamy / ; Hans U Bucher / ; Jean-Claude Fauchere / ; Vera Dietz / ; Chidambara Harikumar / ; Win Tin / ; Susan Fritz / ; Barbara Schmidt / ; Peter J Anderson / ; Elizabeth V Asztalos / ; Keith J Barrington / ; Peter G Davis / ; Deborah Dewey / ; Lex W Doyle / ; Ruth E Grunau / ; Diane Moddemann / ; Arne Ohlsson / ; Robin S Roberts / ; Alfonso Solimano / ; Win Tin / ; Michael Gent / ; William Fraser / ; Edmund Hey / ; Max Perlman / ; Kevin Thorpe / ; Shari Gray / ; Robin S Roberts / ; Carole Chambers / ; Lorrie Costantini / ; Wendy Yacura / ; Erin McGean / ; Lori Scapinello /
Comments/Corrections
Comment In:
JAMA. 2012 Jan 18;307(3):304-5   [PMID:  22253397 ]

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