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Long-Term Neurodevelopmental Outcome after Doxapram for Apnea of Prematurity.
Ten Hove, Christine H; Vliegenthart, Roseanne J; Te Pas, Arjan B; Brouwer, Emma; Rijken, Monique; van Wassenaer-Leemhuis, Aleid G; van Kaam, Anton H; Onland, Wes.
Affiliation
  • Ten Hove CH; Department of Neonatology, Emma Children's Hospital, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
Neonatology ; 110(1): 21-6, 2016.
Article in En | MEDLINE | ID: mdl-26967910
ABSTRACT

BACKGROUND:

Doxapram has been advocated as a treatment for persistent apnea of prematurity (AOP).

OBJECTIVE:

To evaluate the effect of doxapram on long-term neurodevelopmental outcome in preterm infants as its safety still needs to be established.

METHODS:

From a retrospective cohort of preterm infants with a gestational age (GA) <30 weeks and/or a birth weight <1,250 g, born between 2000 and 2010, infants treated with doxapram (n = 142) and a nontreated control group were selected (n = 284). Patient characteristics and clinical and neurodevelopmental outcome data at 24 months' corrected age were collected. Neurodevelopmental delay (ND) was defined as having a Mental or Psychomotor Developmental Index (MDI/PDI) <-1 standard deviation (SD), cerebral palsy, or a hearing or visual impairment. Odds ratios (OR) were calculated using multiple logistic regression analyses adjusting for potential confounders.

RESULTS:

Infants treated with doxapram had a lower GA compared to controls. The number of infants with a MDI or PDI <-1 SD was not different between the groups. The risk of the combined outcome death or ND was significantly lower in the doxapram group after adjusting for confounding factors (OR = 0.54, 95% CI 0.37, 0.78). Doxapram-treated infants had a higher risk of bronchopulmonary dysplasia and patent ductus arteriosus, but a lower risk of spontaneous intestinal perforation. All other morbidities were not different between the groups.

CONCLUSIONS:

This study suggests that doxapram is not associated with an increased risk of ND. These findings need to be confirmed or refuted by a large, well-designed, placebo-controlled randomized trial.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Apnea / Doxapram / Central Nervous System Stimulants / Infant, Premature, Diseases Type of study: Etiology_studies / Observational_studies / Prognostic_studies Limits: Female / Humans / Infant / Male / Newborn Country/Region as subject: Europa Language: En Journal: Neonatology Journal subject: PERINATOLOGIA Year: 2016 Document type: Article Affiliation country: Netherlands

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Apnea / Doxapram / Central Nervous System Stimulants / Infant, Premature, Diseases Type of study: Etiology_studies / Observational_studies / Prognostic_studies Limits: Female / Humans / Infant / Male / Newborn Country/Region as subject: Europa Language: En Journal: Neonatology Journal subject: PERINATOLOGIA Year: 2016 Document type: Article Affiliation country: Netherlands