Abstract 1417 Poster Session III, Monday, 5/3 (poster 17)

Objectives: Methylxanthines, including theophylline, have been used extensively and successfully to treat apnea in preterm infants. However, long-term consequences of such therapy are largely unknown. Experiments in preterm animals suggest methylxanthines may have adverse effects on the developing brain. The aim of this study was to determine the relationship between theophylline therapy and neurological outcome at 14 years of age in surviving children of birthweight <1501 g. Study design: The subjects of this study were 154 consecutive survivors with birthweights <1501 g born from October 1, 1980, to March 31, 1982; 130 (84.4%) were assessed at 14 years of age. Outcomes included motor function and psychological test scores. Results: Of the children seen at 14, 69 had been exposed to theophylline; 9 (13%) had cerebral palsy at 14, significantly higher than 1 (1.6%) in the 61 not exposed to theophylline (p<0.02). This difference remained statistically significant after adjusting for potential confounding variables including presence of cerebroventricular hemorrhage, social class and gestational age. On standardized testing more children in the theophylline group had poor motor function, but the difference was not statistically significant (NS). In contrast, after adjusting for known confounding variables, children who had received theophylline achieved higher verbal IQ scores on the WISC-III. (Table) Conclusions: Theophylline therapy in the newborn period is associated with some evidence of harmful, but also helpful sensorineural effects at 14 years of age. The association between methylxanthine usage and cerebral palsy demonstrated in this cohort warrants further investigation. Proof of a causative link requires a large-scale randomised trial, justified in this case because of the almost universal use of methylxanthines in extremely premature neonates.

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