Researcher of U of C studies the results of preterm infants with caffeine therapy



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Dr. Abhay Lodha with Avril Strachan and her daughter Anna at the Alberta Children's Hospital on December 11, 2018.

Darren Makowichuk / Postmedia

A new study conducted by researchers at the University of Calgary found long-term benefits of giving caffeine therapy in the first two days of life for preterm infants born less than 29 weeks.

The study incorporated data from 26 neonatal intensive care units across Canada and was published in the journal Pediatrics. The research found that early treatment with caffeine does not have long-term negative effects on neurodevelopment and is associated with better cognitive scores and reduced chance of cerebral palsy and hearing impairment.

Dr. Abhay Lodha, a neonatologist at Alberta Health Services and an associate professor at Cumming School of Medicine at the University of Calgary, said the study further strengthens the argument for giving caffeine to premature babies.

"I think caffeine should be given early in the ICU when you have premature babies born less than 29 weeks," Lodha said in an interview at Alberta Children's Hospital on Tuesday.

"We should be more proactive giving caffeine on Day 1 or Day 2 of life. The sooner you give, the better the effect – immediately, as well as the long-term results. "

Caffeine is the drug most commonly used in the neonatal intensive care unit (or NICU) after antibiotics, Lodha said. Babies are usually given therapy until they are at least 34 or 35 weeks old, and until they are able to sustain their breath.

"Their breathing centers are immature in the brain, so that's why they forget to breathe," Lodha said. "That's why we started caffeine right from the start."

A study conducted in 2014 by Lodha showed that starting caffeine therapy within two days after birth shortened the amount of time infants had to use ventilators and reduced the risk of developing a form of chronic lung disease called bronchopulmonary dysplasia.

The follow-up study was launched to understand how caffeine therapy affects brain development. A team of researchers from the universities of British Columbia, Montreal, Toronto and Mount Sinai Hospital in Toronto studied follow-up evaluations from 18 months to 24 months and compared patients who received caffeine two days postpartum with those who started therapy after the childbirth. those first two days.

Sue Makarchuk, an AHS registered psychologist, said that psychologists often see preterm infants for follow-up when they are about 21 months old.

"We run them through a variety of different joking-based tasks just to observe how they are developing in a variety of different domains, mostly cognitive or problem-solving, some languages ​​and also some engines depending on what other therapists are Working. with them that day, "she said.

Avril Strachan's daughter, Anna, was born at 27 weeks and six days and was in the ICU for 80 days. The baby received caffeine to help her breathe and improve lung function.

"You never know how they're going to do it when they leave, but it really, really well from the start," Strachan said.

"You have to leave them behind every day, which is the worst part. . . but it was just like a speck in our story and now we're off and running. "

Now two years old, Anna is attending dance classes, gym classes and swimming.

"I think anything we can give them to get a good start for life is very important," said Strachan on the study of caffeine therapy.

"It's just one of the many things they can do to help them grow and grow strong, and I think everything we can do for them is great."

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