Survival Without Disability to Age 5 Years After Neonatal Caffeine Therapy for Apnea of Prematurity
Bibliographic record
Abstract
Apnea of prematurity is associated with increased risk of death or disability in very preterm infants. An International randomized placebo-controlled study, the Caffeine for Apnea of Prematurity trial, demonstrated that neonatal caffeine therapy reduced rates of neonatal morbidities, including cerebral palsy and cognitive delay, and improved survival in infants at 18 to 21 months of age. It is unclear whether the beneficial effects of caffeine are maintained in older infants. Further, there is also concern that neonatal caffeine exposure may cause long-term harm. This 5-year follow-up study of Caffeine for Apnea of Prematurity was designed to determine the possible lasting benefits of caffeine therapy or newly apparent risks at 5 years of age. Of the 2006 participants from 35 clinical centers in the initial trial conducted between 1999 and 2004, 1932 (96.3%) from 31 clinical centers were enrolled in this follow-up study between 2005 and 2011. The primary study outcome measures were a composite of death or survival before a corrected age of 5 years with one or more of the following: motor impairment (cerebral palsy), cognitive impairment (delay), behavior problems, poor general health, severe hearing loss, and bilateral blindness. Motor impairment was defined as a Gross Motor Function Classification System level of 3 to 5 and cognitive impairment as a Full Scale Intelligence Quotient <70. The odds ratio for the comparisons was adjusted for center. There was no statistically significant difference for the combined outcome of death or disability at 5 years of age between the 833 children assigned to caffeine and the 807 children assigned to placebo (21.1% vs. 24.8%); the adjusted odds ratio was 0.82, with a 95% confidence interval of 0.65–1.03 (P = 0.09). No significant difference was found between the 2 groups for rates of death, motor impairment, behavior problems, poor general health, deafness, and blindness. The rates of cognitive impairment were lower at 5 years than at 18 months and similar in the caffeine and placebo groups (4.9% vs. 5.1%; adjusted odds ratio, 0.97; 95% confidence interval, 0.61–1.55 [P = 0.89]). These findings show that the benefits of neonatal caffeine therapy on the rate of survival without disability at 18 months in very preterm infants were attenuated at 5 years of age.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.030 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".