title: Long-Term Neurodevelopmental Outcome after Doxapram for Apnea of Prematurity.
abstract: Doxapram has been advocated as a treatment for persistent apnea of prematurity (AOP).
  
  
  
  To evaluate the effect of doxapram on long-term neurodevelopmental outcome in preterm infants as its safety still needs to be established.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Neonatology, Emma Children's Hospital, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Christine H
authors.initials: CH
authors.lastname: Ten Hove
authors.forename: Roseanne J
authors.initials: RJ
authors.lastname: Vliegenthart
authors.forename: Arjan B
authors.initials: AB
authors.lastname: Te Pas
authors.forename: Emma
authors.initials: E
authors.lastname: Brouwer
authors.forename: Monique
authors.initials: M
authors.lastname: Rijken
authors.forename: Aleid G
authors.initials: AG
authors.lastname: van Wassenaer-Leemhuis
authors.forename: Anton H
authors.initials: AH
authors.lastname: van Kaam
authors.forename: Wes
authors.initials: W
authors.lastname: Onland
mesh_terms: D001049:Apnea / Q000188:drug therapy*; D001997:Bronchopulmonary Dysplasia / Q000139:chemically induced; D000697:Central Nervous System Stimulants / Q000008:administration & dosage* / Q000009:adverse effects; D002657:Child Development / Q000187:drug effects; D004315:Doxapram / Q000008:administration & dosage* / Q000009:adverse effects; D004374:Ductus Arteriosus, Patent / Q000139:chemically induced; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D019102:Infant, Very Low Birth Weight; D016015:Logistic Models; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D004315:Doxapram