Effect of caffeine on preterm infants’ cerebral cortical activity: an observational study

Abstract

Objective: Our first aim was to investigate the effects of caffeine on preterm infants' respiratory functions and brain cortical activity (conventional and amplitude-integrated electroencephalography (cEEG and aEEG)). Secondary aim was to study its long-term effects on respiratory system and electroencephalographic maturation by 36 weeks post-menstrual age.

Methods: Prospective observational study on 33 consecutively admitted preterm infants less than 34-weeks-gestation. cEEG and aEEG, cardiopulmonary and sleep state were recorded in 20 preterm infants, before, during and 2-hours after intravenous (IV) caffeine (caffeine Group), and for 13 preterms (control group). Both groups were subjected to assessment of cerebral cortical maturation by cEEG and aEEG at 36-weeks post-menstrual age as an outcome measure.

Results: IV caffeine administration significantly increased heart rate (p = 0.000), mean arterial blood pressure (p = 0.000), capillary oxygen saturation (p = 0.003), arousability (p = 0.000) and aEEG continuity (p = 0.002) after half an hour. No clinical seizures were recorded and non-significant difference was found in electrographic seizures activity in cEEG. At 36-weeks post-conceptional age, NICU stay was significantly longer in controls (p = 0.022). aEEG score was significantly higher in caffeine group than the control group, (p = 0.000).

Conclusions: Caffeine increases preterm infants’ cerebral cortical activity during infusion and results in cerebral cortical maturation at 36weeks, without increase in seizure activity.

• Amplitude-integrated electroencephalography
• apnea of prematurity
• cerebral cortical maturity
• conventional electroencephalography
• hospital stay

Acknowledgements

Thanks to all of the team caring for the sick neonates in the Neonatal Intensive Care, Faculty of Medicine, Ain Shams University. They helped us throughout the study by giving the best care for the preemies.

Declaration of interest

The authors have no conflicts of interests to be declared. The authors report no funding relevant to the manuscript.