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Can caffeine from birth prevent disability in preterm babies

Can caffeine from birth prevent disability in mildly preterm babies?

Could caffeine given from birth help prevent developmental impairment in babies born four to six weeks early?

Dr Jane Alsweiler, senior lecturer in Paediatrics at the University of Auckland, plans to answer that question with a clinical trial, but in the meantime she’ll be working on another critical question that her trial depends on: how much caffeine to give?

Dr Alsweiler has just been awarded a Feasibility Study grant worth $249,513 from the Health Research Council of New Zealand (HRC) to determine the most effective dose of caffeine to use in babies this young.

Over 3,500 babies in New Zealand are born ‘late preterm’ (four to six weeks early) every year and are at greater risk of disability when they get older than babies born at term, she says.

This may be because late preterm babies frequently have drops in the amount of oxygen in their blood for the first few weeks after birth.

Dr Alsweiler says it’s been known for some years that in very preterm babies (more than eight weeks early) treatment with caffeine not only reduces apnoea (pauses in breathing) and hypoxaemia (recurrent drops in oxygen saturation), but also improves long-term brain development. It’s not known, however, if caffeine can do the same for late preterm babies.

She is planning a multi-centre, randomised, placebo-controlled trial (the Latte trial) on babies born between 34 and 36 weeks.

“If successful, the Latte trial will change the management and improve outcomes of late pre-term babies,” she says.

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“As caffeine treatment is inexpensive, and long-term neurodevelopmental impairment is costly, there is also the potential for an economic benefit for New Zealand’s healthcare system.”

The HRC’s chief executive, Professor Kath McPherson, says large studies like this could not get off the ground without preliminary issues being addressed first.

Feasibility Study grants go towards testing the critical, practical issues affecting a planned larger study. The Health Research Council this year received 31 applications for these grants, and gave approval to nine, totalling $2,230,458.

“We’re committed to ensuring the greatest benefit for New Zealanders, and for New Zealand, from all of our research investment,” says Professor McPherson.

“Feasibility studies are a key pathway to allow researchers to innovate, but also address potential deal-breakers or risks to a larger study. We fund these early and smaller studies to maximise the chance that future and larger studies are successful.”

See below for the full list of 2018 HRC Feasibility Study grants, and to read lay summaries of the research projects, go to www.hrc.govt.nz/funding-opportunities/recipients and filter for ‘Researcher Initiated Proposals’, ‘Feasibility Studies’ and ‘2018’.

2018 Feasibility Study Grants – full list

Dr Jane Alsweiler, The University of Auckland

Caffeine prophylaxis to improve neurodevelopment in babies born late preterm

24 months, $249,513

Professor Stephen Chambers, University of Otago, Christchurch

Feasibility study of vitamin C therapy in community acquired pneumonia

18 months, $250,000

Dr Sarah Cullum, The University of Auckland

Is a dementia prevalence study feasible in NZ?

15 months, $249,311

Professor Philip Hill, University of Otago, Wellington

Towards elimination of tuberculosis in Māori through preventive treatment

24 months, $250,000

Professor Ngaire Kerse, The University of Auckland

People with dementia and robots for independence

24 months, $248,490

Dr Michal Kluger, Waitemata DHB

STRIDE - Steroids To Reduce the Impact on DElirium study

18 months, $249,840

Dr Jon Mathy, Counties Manukau DHB

Prophylactic InCisional Antibiotics in Skin Surgery (PICASSo trial) feasibility

24 months, $248,477

Dr Andrew McDaid, The University of Auckland

Automated over-ground gait rehabilitation in acute stroke: A Feasibility Study

12 months, $237,839

Professor Richard Porter, University of Otago, Christchurch

Social rhythms therapy for bipolar disorder in routine clinical practice

24 months, $246,985


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