Abstract Asthma complicates between 0.4% and 1.3% of all gestations.1 Theophylline is the mainstay of outpatient treatment. Caffeine from coffee, tea, or cola is ingested by 95% of all women during their pregnancies; it is often found in cord blood, with mean values of 1.0 to 1.6 μg/mL of whole blood, and levels greater than 3 μg/mL were found in 13% of the women studied in one survey.2 Despite the frequent use of caffeine and theophylline, to our knowledge signs of neonatal withdrawal have not yet been reported. We studied a newborn with apnea that was possibly related to withdrawal of theophylline. Report of a Case.—A 3,000-g child was born after a 37½-week gestation to a 34-year-old woman. The pregnancy was complicated by maternal asthma. Medications taken daily during pregnancy included 300 mg of hydrous aminophylline (Aminodur Dura-tabs, two tablets thrice daily), a combination of 50 mg of References 1. Turner ES, Greenberger PA, Patterson R: Management of the pregnant asthmatic patient . Ann Intern Med 1980;93:905-918.Crossref 2. Soyka LF: Effects of methylxanthines on the fetus . Clin Perinatol 1979;6:37-51. 3. Yeh TF, Pildes RS: Transplacental aminophylline toxicity in a neonate . Lancet 1977; 1:910.Crossref 4. Parsons WD, Aranda JV, Neims AH: Elimination of transplacentally acquired caffeine in neonates . Pediatr Res 1976;10:333. 5. Boddy K, Dawes GS: Fetal breathing . Br Med Bull 1975;31:3-7. 6. Piercy WN, May MA, Neims AH, et al: Alteration of ovine fetal respiratory-like activity by diazepam, caffeine, and doxapram . Am J Obstet Gynecol 1977;127:43-49. 7. Shannon DC, Gotay F, Stein IM, et al: Prevention of apnea and bradycardia in low birthweight infants . Pediatrics 1975;55:589-594. 8. Gerhardt T, McCarthy J, Bancalari E: Effect of aminophylline on respiratory center activity and metabolic rate in premature infants with idiopathic apnea . Pediatrics 1979;63:537-542. 9. Davi MJ, San Karan K, Simons KJ, et al: Physiologic changes induced by theophylline in the treatment of apnea in preterm infants . J Pediatr 1979;92:91-95.Crossref 10. Gerhardt T, McCarthy J, Bancalari E: Aminophylline therapy for idiopathic apnea in premature infants: Effect on lung function . Pediatrics 1978;62:801-804. 11. Myers TF, Milsap RL, Krauss AN, et al: Low dose theophylline therapy in idiopathic apnea of prematurity . J Pediatr 1980;96:99-103.Crossref 12. Bory C, Baltassat P, Porthault P, et al: Metabolism of theophylline to caffeine in premature infants . J Pediatr 1979;94:988-993.Crossref
American Journal of Diseases of Children – American Medical Association
Published: Jan 1, 1982
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