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Caffeine citrate for very preterm infants: Effects on development, temperament and behaviour
Aim: To compare two dosing regimens for caffeine citrate for neonates born less than 30 weeks gestation in terms of development, temperament and behaviour. Methods: A multi‐centre, randomised, controlled trial design was undertaken. A total of 287 infants with apnoea of prematurity or in the peri‐...
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| Published in: | Journal of paediatrics and child health 2011-04, Vol.47 (4), p.167-172 |
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| creator | Gray, Peter H Flenady, Vicki J Charles, Bruce G Steer, Peter A |
| description | Aim: To compare two dosing regimens for caffeine citrate for neonates born less than 30 weeks gestation in terms of development, temperament and behaviour.
Methods: A multi‐centre, randomised, controlled trial design was undertaken. A total of 287 infants with apnoea of prematurity or in the peri‐extubation period were randomised to receive one of two dosage regimens (20 vs. 5 mg/kg/day). The main outcome measure was cognitive development at 1 year of age on the Griffiths Mental Development Scales. Secondary outcome measures included neonatal morbidity, death and disability, temperament at 1 year and behaviour at 2 years of age.
Results: Data on the primary outcome were available for 190 survivors at 12 months corrected for prematurity. A significantly greater mean general quotient was found in the high‐dose group (mean (standard deviation), 98.0 (13.8) vs. 93.6 (16.5), P= 0.048). On omission of two infants for whom cognitive assessment was not possible because of disability while the mean general quotient remained higher for infants in the high‐dose group, this was no longer statistically significant (P= 0.075). There was a non‐significant trend for benefit in the high‐dose caffeine group for death or major disability, 15.4% versus 24.2%; relative risk 0.75 (95% confidence interval 0.49–1.14). No differences in the mean values between the two groups were shown for temperament and behaviour.
Conclusions: Caffeine citrate with a dosage regimen of 20 mg/kg/day did not result in adverse outcomes for development, temperament and behaviour. The borderline benefit in cognition with high‐dose caffeine needs further investigation. |
| doi_str_mv | 10.1111/j.1440-1754.2010.01943.x |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_879478352</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>879478352</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4653-7301fecc268e1bbe2927310631d928d5d2b6c1403afbc747cacff8a3eb576f9a3</originalsourceid><addsrcrecordid>eNqNkUtvEzEUhS0EoiXwF5DFhg0T_Bx7kFiUUBpQxUMqYoNkeTzXYsK8sJ2Q_Hs8pGTBqt7c6-vvHOvqIIQpWdJ8Xm6WVAhSUCXFkpE8JbQSfLm_h85PD_dzT7gohKbkDD2KcUMIYVLqh-iMUSaEFPocfV9Z76EdALs2BZsA-zHgHYQDngIkCD1uB2-HFF_hy0y6FPE44AZ20I1TD0N6gRP0EwQ7X7AdGlzDD7trx214jB5420V4clsX6Ou7y5vVurj-dPV-dXFdOFFKXihOaHZ2rNRA6xpYxRSnpOS0qZhuZMPq0lFBuPW1U0I567zXlkMtVekryxfo-dF3CuOvLcRk-jY66Do7wLiNRqtKKM0luwNJpOQk_71Az_4jN3mjIa9hdMkqXlVshvQRcmGMMYA3U2h7Gw6GEjMnZTZmDsTMgZg5KfM3KbPP0qe3_tu6h-Yk_BdNBl4fgd9tB4c7G5sPn1dzl_XFUd_GBPuT3oafplRcSfPt45Wh65s36y9rYd7yPwS4sJM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>862939926</pqid></control><display><type>article</type><title>Caffeine citrate for very preterm infants: Effects on development, temperament and behaviour</title><source>Wiley</source><creator>Gray, Peter H ; Flenady, Vicki J ; Charles, Bruce G ; Steer, Peter A</creator><creatorcontrib>Gray, Peter H ; Flenady, Vicki J ; Charles, Bruce G ; Steer, Peter A ; Caffeine Collaborative Study Group ; on behalf of the Caffeine Collaborative Study Group</creatorcontrib><description>Aim: To compare two dosing regimens for caffeine citrate for neonates born less than 30 weeks gestation in terms of development, temperament and behaviour.
Methods: A multi‐centre, randomised, controlled trial design was undertaken. A total of 287 infants with apnoea of prematurity or in the peri‐extubation period were randomised to receive one of two dosage regimens (20 vs. 5 mg/kg/day). The main outcome measure was cognitive development at 1 year of age on the Griffiths Mental Development Scales. Secondary outcome measures included neonatal morbidity, death and disability, temperament at 1 year and behaviour at 2 years of age.
Results: Data on the primary outcome were available for 190 survivors at 12 months corrected for prematurity. A significantly greater mean general quotient was found in the high‐dose group (mean (standard deviation), 98.0 (13.8) vs. 93.6 (16.5), P= 0.048). On omission of two infants for whom cognitive assessment was not possible because of disability while the mean general quotient remained higher for infants in the high‐dose group, this was no longer statistically significant (P= 0.075). There was a non‐significant trend for benefit in the high‐dose caffeine group for death or major disability, 15.4% versus 24.2%; relative risk 0.75 (95% confidence interval 0.49–1.14). No differences in the mean values between the two groups were shown for temperament and behaviour.
Conclusions: Caffeine citrate with a dosage regimen of 20 mg/kg/day did not result in adverse outcomes for development, temperament and behaviour. The borderline benefit in cognition with high‐dose caffeine needs further investigation.</description><identifier>ISSN: 1034-4810</identifier><identifier>EISSN: 1440-1754</identifier><identifier>DOI: 10.1111/j.1440-1754.2010.01943.x</identifier><identifier>PMID: 21244548</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Age ; Australia - epidemiology ; behaviour ; Caffeine ; Caffeine - administration & dosage ; Caffeine - pharmacology ; Central Nervous System Stimulants - administration & dosage ; Central Nervous System Stimulants - pharmacology ; Child Development - drug effects ; Citrates - administration & dosage ; Citrates - pharmacology ; Clinical outcomes ; clinical trials ; cognitive ability ; development ; disabilities ; Dose-Response Relationship, Drug ; Female ; Gestational Age ; Humans ; Infant ; Infant Behavior - drug effects ; Infant Mortality - trends ; Infant, Newborn ; Infants ; Male ; Morbidity ; Mortality ; Neonatal care ; Neonates ; Pediatrics ; Premature Birth ; preterm ; Surveys and Questionnaires ; temperament ; Temperament - drug effects</subject><ispartof>Journal of paediatrics and child health, 2011-04, Vol.47 (4), p.167-172</ispartof><rights>2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians)</rights><rights>2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4653-7301fecc268e1bbe2927310631d928d5d2b6c1403afbc747cacff8a3eb576f9a3</citedby><cites>FETCH-LOGICAL-c4653-7301fecc268e1bbe2927310631d928d5d2b6c1403afbc747cacff8a3eb576f9a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1440-1754.2010.01943.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1440-1754.2010.01943.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21244548$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gray, Peter H</creatorcontrib><creatorcontrib>Flenady, Vicki J</creatorcontrib><creatorcontrib>Charles, Bruce G</creatorcontrib><creatorcontrib>Steer, Peter A</creatorcontrib><creatorcontrib>Caffeine Collaborative Study Group</creatorcontrib><creatorcontrib>on behalf of the Caffeine Collaborative Study Group</creatorcontrib><title>Caffeine citrate for very preterm infants: Effects on development, temperament and behaviour</title><title>Journal of paediatrics and child health</title><addtitle>J Paediatr Child Health</addtitle><description>Aim: To compare two dosing regimens for caffeine citrate for neonates born less than 30 weeks gestation in terms of development, temperament and behaviour.
Methods: A multi‐centre, randomised, controlled trial design was undertaken. A total of 287 infants with apnoea of prematurity or in the peri‐extubation period were randomised to receive one of two dosage regimens (20 vs. 5 mg/kg/day). The main outcome measure was cognitive development at 1 year of age on the Griffiths Mental Development Scales. Secondary outcome measures included neonatal morbidity, death and disability, temperament at 1 year and behaviour at 2 years of age.
Results: Data on the primary outcome were available for 190 survivors at 12 months corrected for prematurity. A significantly greater mean general quotient was found in the high‐dose group (mean (standard deviation), 98.0 (13.8) vs. 93.6 (16.5), P= 0.048). On omission of two infants for whom cognitive assessment was not possible because of disability while the mean general quotient remained higher for infants in the high‐dose group, this was no longer statistically significant (P= 0.075). There was a non‐significant trend for benefit in the high‐dose caffeine group for death or major disability, 15.4% versus 24.2%; relative risk 0.75 (95% confidence interval 0.49–1.14). No differences in the mean values between the two groups were shown for temperament and behaviour.
Conclusions: Caffeine citrate with a dosage regimen of 20 mg/kg/day did not result in adverse outcomes for development, temperament and behaviour. The borderline benefit in cognition with high‐dose caffeine needs further investigation.</description><subject>Age</subject><subject>Australia - epidemiology</subject><subject>behaviour</subject><subject>Caffeine</subject><subject>Caffeine - administration & dosage</subject><subject>Caffeine - pharmacology</subject><subject>Central Nervous System Stimulants - administration & dosage</subject><subject>Central Nervous System Stimulants - pharmacology</subject><subject>Child Development - drug effects</subject><subject>Citrates - administration & dosage</subject><subject>Citrates - pharmacology</subject><subject>Clinical outcomes</subject><subject>clinical trials</subject><subject>cognitive ability</subject><subject>development</subject><subject>disabilities</subject><subject>Dose-Response Relationship, Drug</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant Behavior - drug effects</subject><subject>Infant Mortality - trends</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Male</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Neonatal care</subject><subject>Neonates</subject><subject>Pediatrics</subject><subject>Premature Birth</subject><subject>preterm</subject><subject>Surveys and Questionnaires</subject><subject>temperament</subject><subject>Temperament - drug effects</subject><issn>1034-4810</issn><issn>1440-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNqNkUtvEzEUhS0EoiXwF5DFhg0T_Bx7kFiUUBpQxUMqYoNkeTzXYsK8sJ2Q_Hs8pGTBqt7c6-vvHOvqIIQpWdJ8Xm6WVAhSUCXFkpE8JbQSfLm_h85PD_dzT7gohKbkDD2KcUMIYVLqh-iMUSaEFPocfV9Z76EdALs2BZsA-zHgHYQDngIkCD1uB2-HFF_hy0y6FPE44AZ20I1TD0N6gRP0EwQ7X7AdGlzDD7trx214jB5420V4clsX6Ou7y5vVurj-dPV-dXFdOFFKXihOaHZ2rNRA6xpYxRSnpOS0qZhuZMPq0lFBuPW1U0I567zXlkMtVekryxfo-dF3CuOvLcRk-jY66Do7wLiNRqtKKM0luwNJpOQk_71Az_4jN3mjIa9hdMkqXlVshvQRcmGMMYA3U2h7Gw6GEjMnZTZmDsTMgZg5KfM3KbPP0qe3_tu6h-Yk_BdNBl4fgd9tB4c7G5sPn1dzl_XFUd_GBPuT3oafplRcSfPt45Wh65s36y9rYd7yPwS4sJM</recordid><startdate>201104</startdate><enddate>201104</enddate><creator>Gray, Peter H</creator><creator>Flenady, Vicki J</creator><creator>Charles, Bruce G</creator><creator>Steer, Peter A</creator><general>Blackwell Publishing Asia</general><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201104</creationdate><title>Caffeine citrate for very preterm infants: Effects on development, temperament and behaviour</title><author>Gray, Peter H ; Flenady, Vicki J ; Charles, Bruce G ; Steer, Peter A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4653-7301fecc268e1bbe2927310631d928d5d2b6c1403afbc747cacff8a3eb576f9a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Age</topic><topic>Australia - epidemiology</topic><topic>behaviour</topic><topic>Caffeine</topic><topic>Caffeine - administration & dosage</topic><topic>Caffeine - pharmacology</topic><topic>Central Nervous System Stimulants - administration & dosage</topic><topic>Central Nervous System Stimulants - pharmacology</topic><topic>Child Development - drug effects</topic><topic>Citrates - administration & dosage</topic><topic>Citrates - pharmacology</topic><topic>Clinical outcomes</topic><topic>clinical trials</topic><topic>cognitive ability</topic><topic>development</topic><topic>disabilities</topic><topic>Dose-Response Relationship, Drug</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant Behavior - drug effects</topic><topic>Infant Mortality - trends</topic><topic>Infant, Newborn</topic><topic>Infants</topic><topic>Male</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Neonatal care</topic><topic>Neonates</topic><topic>Pediatrics</topic><topic>Premature Birth</topic><topic>preterm</topic><topic>Surveys and Questionnaires</topic><topic>temperament</topic><topic>Temperament - drug effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gray, Peter H</creatorcontrib><creatorcontrib>Flenady, Vicki J</creatorcontrib><creatorcontrib>Charles, Bruce G</creatorcontrib><creatorcontrib>Steer, Peter A</creatorcontrib><creatorcontrib>Caffeine Collaborative Study Group</creatorcontrib><creatorcontrib>on behalf of the Caffeine Collaborative Study Group</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Journal of paediatrics and child health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gray, Peter H</au><au>Flenady, Vicki J</au><au>Charles, Bruce G</au><au>Steer, Peter A</au><aucorp>Caffeine Collaborative Study Group</aucorp><aucorp>on behalf of the Caffeine Collaborative Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Caffeine citrate for very preterm infants: Effects on development, temperament and behaviour</atitle><jtitle>Journal of paediatrics and child health</jtitle><addtitle>J Paediatr Child Health</addtitle><date>2011-04</date><risdate>2011</risdate><volume>47</volume><issue>4</issue><spage>167</spage><epage>172</epage><pages>167-172</pages><issn>1034-4810</issn><eissn>1440-1754</eissn><notes>istex:4CA67D8F496AEEC71B097CB9625D773435D00B14</notes><notes>ArticleID:JPC1943</notes><notes>ark:/67375/WNG-1HTBHQH4-D</notes><notes>Caffeine Collaborative Study Group: Mater Mothers' Research Centre, Mater Mothers' Hospital, The University of Queensland, South Brisbane, Queensland, Australia: PA Steer, PH Gray, V Flenady, A Shearman, J Hegarty and Y Rogers (deceased). School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, Queensland, Australia: BG Charles. Royal Prince Alfred Hospital, Sydney, New South Wales, Australia: D Henderson‐Smart and S Reid. Mercy Hospital for Women, Melbourne, Victoria, Australia: S Fraser, R Jacklin, A Walsh and M Charlton. Royal Hobart Hospital, Hobart, Tasmania, Australia: G Bury and L Horton.</notes><notes>Current affiliation: Children's Health Service, Queensland Health, South Brisbane, QLD, Australia.</notes><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-News-2</notes><notes>ObjectType-Feature-3</notes><notes>content type line 23</notes><notes>ObjectType-Article-2</notes><notes>ObjectType-Feature-1</notes><abstract>Aim: To compare two dosing regimens for caffeine citrate for neonates born less than 30 weeks gestation in terms of development, temperament and behaviour.
Methods: A multi‐centre, randomised, controlled trial design was undertaken. A total of 287 infants with apnoea of prematurity or in the peri‐extubation period were randomised to receive one of two dosage regimens (20 vs. 5 mg/kg/day). The main outcome measure was cognitive development at 1 year of age on the Griffiths Mental Development Scales. Secondary outcome measures included neonatal morbidity, death and disability, temperament at 1 year and behaviour at 2 years of age.
Results: Data on the primary outcome were available for 190 survivors at 12 months corrected for prematurity. A significantly greater mean general quotient was found in the high‐dose group (mean (standard deviation), 98.0 (13.8) vs. 93.6 (16.5), P= 0.048). On omission of two infants for whom cognitive assessment was not possible because of disability while the mean general quotient remained higher for infants in the high‐dose group, this was no longer statistically significant (P= 0.075). There was a non‐significant trend for benefit in the high‐dose caffeine group for death or major disability, 15.4% versus 24.2%; relative risk 0.75 (95% confidence interval 0.49–1.14). No differences in the mean values between the two groups were shown for temperament and behaviour.
Conclusions: Caffeine citrate with a dosage regimen of 20 mg/kg/day did not result in adverse outcomes for development, temperament and behaviour. The borderline benefit in cognition with high‐dose caffeine needs further investigation.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>21244548</pmid><doi>10.1111/j.1440-1754.2010.01943.x</doi><tpages>6</tpages></addata></record> |
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| ispartof | Journal of paediatrics and child health, 2011-04, Vol.47 (4), p.167-172 |
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| subjects | Age Australia - epidemiology behaviour Caffeine Caffeine - administration & dosage Caffeine - pharmacology Central Nervous System Stimulants - administration & dosage Central Nervous System Stimulants - pharmacology Child Development - drug effects Citrates - administration & dosage Citrates - pharmacology Clinical outcomes clinical trials cognitive ability development disabilities Dose-Response Relationship, Drug Female Gestational Age Humans Infant Infant Behavior - drug effects Infant Mortality - trends Infant, Newborn Infants Male Morbidity Mortality Neonatal care Neonates Pediatrics Premature Birth preterm Surveys and Questionnaires temperament Temperament - drug effects |
| title | Caffeine citrate for very preterm infants: Effects on development, temperament and behaviour |
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