Early Childhood Developmental Follow-Up of Infants with GMH/IVH: Effect of Methylxanthine Therapy

Theophylline, aminophylline, and caffeine are methylxanthines frequently used in the treatment of idiopathic apnea of prematurity. These agents alter both cerebral blood flow and metabolism and are frequently administered to small preterm neonates, many of whom have experienced germinal matrix and/or intraventricular hemorrhage (GMH/IVH) and thus may suffer underlying disturbances of both cerebral blood flow and metabolism. Our data demonstrate that infants with GMH/IVH required methylxanthine therapy in the neonatal period more often than their nonhemorrhage peers. Because the combined presence of GMH/IVH and methylxanthine therapy may compound the potential for adverse effects in these infants, we analyzed the neurodevelopmental outcome of 73 very-low-birthweight neonates at 18 months corrected age with respect to the presence of GMH/IVH and neonatal methylxanthine therapy. Though further studies are needed, we cautiously conclude that the 18-month Bayley mental score demonstrates no harmful effects of neonatal methylxanthine therapy on cognitive functioning.

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