Prophylactic aminophylline for prevention of apnea at higher-risk preterm neonates.
BACKGROUND
A few studies have been carried on preventive drugs for apnea of preterm neonates.


OBJECTIVE
This study aimed to assess the safety and prophylactic effects of aminophylline on the incidence of apnea in premature neonates.


METHODS
This study was a randomized clinical trial (RCT) research. The prophylactic effect of aminophylline on apnea was investigated in premature babies in our NICU (IRAN-Isfahan). In the study group (A), 5 mg/kg aminophylline was initially administered as a loading dose. Then, every 8 hours, 1.5 mg/kg was given as maintenance dose for the next 10 days. In the control group (C), no aminophylline was used during the first ten days of life.


RESULTS
Fifty-two neonates were randomized for the study and all of them completed it. Primary outcomes were clearly different between the two groups. Only 2 infants (7.7%) who had been placed in aminophylline group developed apnea, as compared to 16 infants (61.5%) in the control group (P < 0.001). Three and four neonates (11.5%, 15.4%) in the aminophylline group developed bradycardia and cyanosis respectively, as compared to 16 infants (61.5%) who did not receive aminophylline (P < 0.001). Median time of need to NCPAP (Nasal Continuous Positive Airway Pressure) was 1 (0 - 4) days and 2.5 (0.5 - 6.5) days in group A and C, respectively (P = 0.03). No side effects were reported in neonates (P > 0.999). Median time of hospitalization was shorter in aminophylline group (P = 0.04).


CONCLUSIONS
This study supports the preventative effects of aminophylline on apnea in extreme premature infants. In other words, the more premature an infant, the greater the preventative effect of aminophylline on the incidence of apnea and bradycardia.
Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran.
Amir Mohammad
AM
Armanian
Department of Pediatrics, Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, IR Iran.
Zohreh
Z
Badiee
Isfahan University of Medical Sciences, Isfahan, IR Iran.
Raha
R
Afghari
Al-Mahdi University, Isfahan, IR Iran.
Nima
N
Salehimehr
Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, IR Iran.
Akbar
A
Hassanzade
NICU Ward, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran.
Soghra
S
Sheikhzadeh
NICU Ward, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran.
Maryam
M
Sharif Tehrani
NICU Ward, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran.
Gohar
G
Rezvan
Aminophylline; Apnea of Prematurity; Methyl xanthine Therapy; Premature Infant