Sunday , January 17 2021

Development of the brains of premature babies takes advantage of caffeine treatment



Too many, it's a must to start the day with caffeine from a cup of coffee. In neonatal intensive units or NICUs premature babies are born for 29 weeks a daily dose of caffeine to ensure the best possible start of life. A recent study by the University of Calgary researchers shows where the earlier dose of caffeine can be given, the better.

"Caffeine is the most commonly used drug in NICU after antibiotics," says Dr. Abhay Lodha, Master of Science. Professor of Educational and Social Sciences institutions at Cumming School of Medicine and employee non-specialist with Alberts Health Services (AHS). "It is important that we understand the long-term effects of caffeine as a treatment and ensure that these babies not only survive but have quality of life on the road."

Born too early 27 weeks at Foothills Medical Center, Kyle and Avril Strachan's baby, Anna, got caffeine to help her breathe and increase lung function.

"Doctors told us with their early babies that their brain has not developed enough to let them do all their bodies have to do on their own to breathe," says Avril. "In the first couple of weeks when Anna fed, she would lower or even forget to breathe. This would make her heart slow and for her not to get enough oxygen."

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

A 2014 study by Lodha showed that starting caffeine treatment within two days after birth shortened the amount of time babies needed to use fans. It also reduced the risk of bronchopulmonary dysplasia (BPD), a form of chronic lung disease caused by lung damage using a ventilator. What was not known was how the dose of caffeine affected the brain's development.

Lodha collaborated with researchers from the universities of British Columbia, Montreal, Toronto and Mount Sinai Hospital in Toronto to analyze data from 26 NICUs in Canada. They found that early caffeine treatment has no long-term negative effects on neuro development, and is actually associated with better cognitive scores and reduced odds for cerebral palsy and impaired hearing. The results are published in Pediatrics.

The team examined data from follow-up assessments conducted between the ages of 18 and 24 months. During these follow-ups, children were assessed for their cognitive, linguistic and motor development using Bayley Scales of Infant and Toddler Development, a standardized scoring system for evaluation of developmental function in infants and young children.

"We look at how children build up their understanding, such as solving simple problems or finding out three-dimensional objects and toys," says Dr. Dianne Creighton, PhD, Assistant Professor of Educational Department and Retired Psychologist with AHS. "We also consider how the little ones can understand simple words or recognize the name of a picture as well as their motor skills like climbing, search, balance and coordination."

Lodha says it is assumed that caffeine can increase the growth of dendrites, the small branches of a neuron that receive signals from other neurons. "Caffeine can also improve lung string and expansion, heart rate and blood pressure in premature infants, which improves oxygen supply throughout the body and brain, reducing the duration of mechanical ventilation and the risk of chronic lung disease and injury to the developing brain."

Now two years old, Anna has completed several follow-up assessments and participates in dance classes, gymnastics and swimming as a fish, says her mother Avril.

"She is very mechanical. She likes to build things, take it apart and find out how it works," she says. "It's great to know that caffeine treatment has no negative effects and that if researchers get positive results, it should continue to be the standard for the care of premature babies. In that case, I think parents would not hesitate to have caffeine as part of their children's treatment. "

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This study was performed with Canadian Canadian Neonatal Network and Canadian Neonatal Monitoring Network, supported by the Maternal-Infant Care Research Center at Mount Sinai Hospital.

Drs. Abhay Lodha and Dianne Creighton are associate members of the Alberts Children's Hospital Research Institute.

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