Caffeine Really Helps Premature Babies
Researchers Say Benefits of Standard Prematurity Treatment Outweigh the Risks
Nov. 7, 2007 -- Caffeine, the standard treatment for breathing problems in
premature infants, really does work, an international study shows.
With official publication of the findings in the Nov. 7 issue of The New
England Journal of Medicine, obstetricians are breathing better, too.
Caffeine has been widely used to help premature infants breathe better, but
until now, nobody really knew whether the drug's benefits outweigh its
You can almost hear the sigh of relief in comments from study leader Barbara
Schmidt, MD, a professor at McMaster University in Hamilton, Ontario,
Canada, and the University of Pennsylvania in Philadelphia.
"It definitely gives hope to parents," Schmidt says in a news release. "Of all
the drugs we use in the neonatal intensive care unit, caffeine is the first to
have been shown conclusively to reduce long-term disability in very preterm
The international study looked at
nearly 2,000 premature babies with very low birth weights ranging from 1.1 to
2.75 pounds. Half the babies were treated with caffeine and half received an
Even with caffeine, the babies
struggled to survive. By ages 18 to 21 months, more than 40% of the babies
treated with caffeine either died or suffered a neurodevelopmental disability
such as cerebral palsy. But that's better than the 46% of
placebo-treated babies who had the same outcomes.
Overall, caffeine cut the rate of
cerebral palsy from 7.3% to 4.4% (a 42% reduction) and cut the rate of
cognitive delay from 38.3% to 33.8% (a 19% reduction). Caffeine had no
significant effect on rates of death, deafness, and
In an editorial accompanying the
study, Stanford University researcher David K. Stevenson, MD, notes that 16
very-low-birth-weight infants would need to be treated with caffeine to prevent
one death or one case of cerebral palsy, cognitive delay, deafness, or
Caffeine did not affect children's
growth rates at this early age. However, the children in the study will be
followed until school age to see whether the benefits of caffeine persist and
whether new risks become evident.
Much of caffeine's benefit is due to the fact that it allows children to
breathe on their own much sooner. However, a lot of the drug's effect remains
Nevertheless, the findings support continued use of caffeine as a treatment
"We can now conclude that the possible risks of [caffeine] therapy have
been 'carefully balanced against the treatment gains' and the gains of therapy
outweigh the risks," Stevenson concludes.