Serum levels of caffeine in umbilical cord and apnea of prematurity.
OBJECTIVE
To determine the influence of presence of caffeine in umbilical cord blood on apnea occurrence.


METHODS
A prospective cohort study with preterm newborns with birth weight lower than 2,000 g was undertaken. Exclusion criteria were: mothers who received opioids; mechanical ventilation during the first 4 days of life; cerebral and major cardiac malformations; perinatal asphyxia; severe periintraventricular hemorrhage; exchange transfusion before the fourth day of life; and those who received methylxanthine prior to extubation. Neonates were divided into detectable and undetectable caffeine in umbilical cord blood. Newborns were followed for the first 4 days for occurrence of apnea spells.


RESULTS
Eighty-seven newborns with and 40 without detectable caffeine in umbilical cord blood were studied. Median caffeine concentration of the 87 patients with detectable caffeine in umbilical blood was 2.3 microg/mL (0.2-9.4 microg/mL). There was no association between occurrence of apnea spells and presence of caffeine in umbilical cord blood. Neonates with detectable caffeine in umbilical blood had borderline later apnea (66.3+/-4.14 hours) than those with undetectable levels (54.2+/-6.26 hours).


CONCLUSIONS
Detected levels of caffeine in umbilical cord blood did not decrease occurrence of apnea of prematurity, but it had a borderline effect delaying its occurrence, suggesting that even a low level of caffeine in umbilical cord blood might delay occurrence of apnea spells.
Hentges
Cláudia Regina
CR
Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
Guedes
Renata Rostirola
RR
Silveira
Rita C
RC
Procianoy
Renato S
RS
D001049:Apnea / Q000097:blood / Q000139:chemically induced*; D001938:Brazil; D002110:Caffeine / Q000009:adverse effects / Q000097:blood*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000097:blood*; D004812:Epidemiologic Methods; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000139:chemically induced*; D008297:Male; D013997:Time Factors
D000697:Central Nervous System Stimulants; D002110:Caffeine