ABSTRACT
Theophylline, aminophylline, and caffeine are methylxanthines frequently used in the
treatment of idiopathic apnea of prematurity. These agents alter both cerebral blood
flow and metabolism and are frequently administered to small preterm neonates, many
of whom have experienced germinal matrix and/or intraventricular hemorrhage (GMH/IVH)
and thus may suffer underlying disturbances of both cerebral blood flow and metabolism.
Our data demonstrate that infants with GMH/IVH required methylxanthine therapy in
the neonatal period more often than their nonhemorrhage peers. Because the combined
presence of GMH/IVH and methylxanthine therapy may compound the potential for adverse
effects in these infants, we analyzed the neurodevelopmental outcome of 73 very-low-birthweight
neonates at 18 months corrected age with respect to the presence of GMH/IVH and neonatal
methylxanthine therapy. Though further studies are needed, we cautiously conclude
that the 18-month Bayley mental score demonstrates no harmful effects of neonatal
methylxanthine therapy on cognitive functioning.
