Saturday , January 16 2021

The development of the brain of premature babies takes advantage of caffeine therapy



For many, starting a free day with caffeine from a cup of coffee is a must. In neonatal intensive care units or NICUs, babies born under 29 weeks receive a daily caffeine dose to ensure the best possible start of life. A new study by researchers at Calgary University shows that the earlier the caffeine dose can be, the better.

"Caffeine is the most commonly used drug in NICU after antibiotics," says Dr. Abhay Lodha, Associate Professor in Pediatrics and Medical Sciences at the Cumming Medical Laboratory and a neonatologist at the Alba Health Services (AHS) Cabinet, "It's Important to understand the long-term effects of caffeine as a treatment, and to ensure that these babies not only survive but also have quality of life on the road. "

Born prematurely at 27 weeks at Fatillis Medical Center, Kyle and Avril Strashan's baby, Anna, received caffeine to help her breathe and strengthen her pulmonary function.

"The doctors told us that in premature babies their brain did not develop enough to allow them to do all the things their bodies need to do themselves, such as breathing," says Mother Avril. "During the first few weeks when Anna was eating, she would have slowed or even forgot to breathe, which would slow her heart and not get enough oxygen."

To help her breathe easier, Anna needed constant positive airway pressure or a CPAP machine to provide a constant airflow into her lungs.

The 2014 Lodha study showed that starting caffeine therapy within two days of birth, shortened the time it takes for babies to use fans. It also reduces the risk of bronchopulmonary dysplasia (BPD), a form of chronic lung disease caused by lung damage using a ventilator. It was not known how this caffeine dose affects the development of the brain.

Lodda collaborates with researchers from the Universities of British Columbia, Montreal, Toronto, and Mount Sinai Hospital in Toronto to analyze 26 NICUs data in Canada. They found that early caffeine treatment had no long-term negative effects on neuroproduction and was in fact associated with better cognitive performance and reduced chance of cerebral palsy and hearing impairment. The findings are published in pediatrics,

The team examined the data from ex-post evaluations conducted at the age of 18 to 24 months. During these follow-up, the children were assessed for their cognitive, linguistic and motor development using the Bayley scale for infant and young children, a standardized assessment system to assess the performance of infants and young children.

"We are looking at how children build their understanding, such as solving simple problems or uncovering 3D objects and toys," said Dr. Dianne Creighton, PhD assistant professor in pediatrics and a retired psychologist at AHS. "We also appreciate how little kids can understand simple words or recognize the name of the picture, as well as their motor skills such as climbing, crawling, balance and coordination."

Loda says that caffeine is believed to increase the growth of dendrites – the small neurons that receive signals from other neurons. "Caffeine can also improve better stretching and enlargement of the lungs, heart rate and blood pressure in premature babies, which improves oxygen delivery in the body and brain, reduces the duration of mechanical ventilation and the risk of chronic lung diseases and injuries to the developing brain. "

Two years ago, Anna has completed many follow-up assessments, and she has been involved in dance lessons, gymnastics lessons and swimming as a fish, her mother Avril says.

"She is very mechanical, she likes to build things, split them up and understand how it works," she says. "It is great to know that treatment with caffeine has no side effects and that if the researchers get positive results, they should continue to be the standards for care for premature babies." In this case, I think parents will not hesitate to have caffeine as a part of the treatment of their child. "

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This study was conducted with data from the Canadian Newborn and Canadian Newborn Tracking Network, which is supported by the Center for the Study of Mothers and Infants at Mount Sinai Hospital.

Drs. Abha Lodha and Diane Crayon are associate members of the Alberta Children's Research Institute.

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