Experiments in sheep suggest that caffeine administration to pregnant women and newborns could potentially prevent cerebral palsy, a disabling condition often caused by oxygen deprivation (asphyxia) around the time of birth. The research, published in Stroke, indicates that caffeine's antioxidant and anti-inflammatory properties may mitigate brain damage associated with asphyxia.
Caffeine's Mechanism of Action
Dr. Emin Maltepe, a neonatologist at the University of California, San Francisco's Benioff Children’s Hospital, explained that caffeine stimulates the respiratory centers in preterm babies and has antioxidant and anti-inflammatory effects. Dr. Jana Mike, a pediatric intensivist at the same hospital, added that caffeine readily crosses the blood-brain barrier.
Study Details and Findings
The study involved administering a single intravenous dose of one gram of caffeine (equivalent to about 10 cups of coffee) or a placebo to 30 pregnant sheep. After the lambs were born and asphyxia was induced, some received a large dose of caffeine followed by smaller doses for two days, while others received a placebo.
The researchers reported that lambs exposed to caffeine had significantly lower levels of systemic inflammation (cytokines) and reduced signs of injury to both gray and white matter in their brains. Additionally, the treated lambs appeared more active, eating and moving around more than the untreated animals. No adverse effects were observed in the ewes.
Potential Impact and Future Directions
Dr. Maltepe expressed enthusiasm about the potential of caffeine to prevent long-term disability in babies with birth asphyxia, particularly in less resourced countries where current treatments are less effective. The researchers noted that 95% of cerebral palsy cases worldwide occur in poorer nations.
The current standard of care for newborns with low oxygen is therapeutic hypothermia, cooling their bodies for 72 hours. However, this treatment is only modestly effective. The researchers suggest that brain hypoxia may occur earlier in gestation due to placental insufficiency.
Dr. Maltepe mentioned that they reviewed over 1,000 drugs and found caffeine to be the most effective in preventing or lessening damage from asphyxia. Clinical trials in women and newborns are being planned at sites worldwide.
The research was funded by the Bill and Melinda Gates Foundation.
