Last update:
14-Sep-2016

Caffeine is used for the treatment of apnea of prematurity as it acts as a respiratory stimulant, but it may affect cognition in later life through complex pathophysiological mechanisms. This is a review of the effects of caffeine administration in the newborn period on later neurological and cognitive function, with clarification of the pathophysiological processes involved. A search was made of the international literature relevant to the subject using international databases, including Medline (search in PubΜed) (1966–2015), Scopus (2004–2015) and ClinicalTrials.gov (2008– 2015). The majority of studies document a beneficial effect. Specifically, caffeine administered for apnea of prematurity appears to be strongly positively associated with such functions as mobility, perception and vision, and with a decrease in the incidence of cerebral palsy. A less powerful beneficial effect of caffeine is that on hearing. Caffeine administration does not appear to affect the quality and duration of sleep, while the EEG findings are conflicting. In contrast, short-term behavior is probably negatively affected, with an increased incidence of anxiety. The pathophysiological pathways involved in these effects have not been fully clarified, but it appears that adenosine receptors are involved, the loss of which leads to aggressive behavior. Another possible pathway involves the neurotrophic factor BDNF, which supports various functions of the developing brain, including learning, memory, differentiation and survival of neurons and synaptic plasticity (long-term support). In conclusion, caffeine use during the neonatal period for the treatment of apnea of prematurity definitely influences neurological and cognitive function later in life. Future studies should accurately determine the size of the dose of caffeine to ensure an optimal therapeutic effect while minimizing its long-term adverse effects. Further clinical trials are needed to clarify the relationship of caffeine with cortical activity of the infantile brain.

Key words: Apnea of prematurity, Caffeine, Cognitive functions.