Long-Term Neurodevelopmental Outcome after Doxapram for Apnea of Prematurity.

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.

journal_name

Neonatology

journal_title

Neonatology

authors

Ten Hove CH,Vliegenthart RJ,Te Pas AB,Brouwer E,Rijken M,van Wassenaer-Leemhuis AG,van Kaam AH,Onland W

doi

10.1159/000444006

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

21-6

issue

1

eissn

1661-7800

issn

1661-7819

pii

000444006

journal_volume

110

pub_type

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