Background: Theophylline was an orally administered xanthine used for the treatment of apnea of prematurity and Bronchopulmonary Dysplasia in the ambulatory follow-up of Low-Birth-Weight infants (LBWI) with oxygen-dependency in the Kangaroo Mother Care Program (KMCP). Theophylline’s main metabolic product is caffeine; therefore, it was an alternative due to the frequent lack of ambulatory oral caffeine in low and middle-income countries. Purpose: to assess the effectiveness of oral Theophylline in decreasing days with oxygen and to describe frequency of adverse related events. Method: quasi-experiment before and after withdrawal of Theophylline given systematically to LBWI with ambulatory oxygen in two KMCPs. Results: 729 patients were recruited; 319 with Theophylline and 410 after Theophylline withdrawn. The Theophylline cohort had less gestational age, less weight at birth, more days in Neonatal Intensive Care Unit, more days of oxygen-dependency at KMCP admission, and more frequencies of Intrauterine Growth Restriction and apneas. After adjusting with propensity score matching, multiple linear regression was done, and analysis showed that nutrition had a greater effect on days of oxygen-dependency than the fact of receiving Theophylline. No differences were found in readmissions up to 40 weeks, nor in the frequency of intraventricular hemorrhage or neurodevelopmental problems. The Theophylline group had more tachycardia episodes. Conclusions: we did not find evidence of oral Theophylline effect on the reduction of days of oxygen-dependency. For the current management of oxygen- dependency in newborns, the importance of KMCPs nutritional protocols based on exclusive breast feeding whenever possible, is the challenge for these fragile infants.

Background: In Bogotá, Colombia, oxygen-dependent (OD) preterm infants are home discharged in Kangaroo Position, to a Kangaroo Mother Care program (KMCP) with ambulatory oxygen, strict follow-up and oxygen weaning protocols. Objectives: 1) to describe growth and morbimortality up to 6 months of an OD preterm infants’ cohort. 2) to explore the association between oxygen requirement, perinatal history, Hb levels, transfusions, feeding patterns and growth. Methods: Prospective cohort study. Descriptive and multivariate analysis. Results: 445 patients were recruited with 33 weeks median gestational age (GA). 21% of mothers had preeclampsia, 50% infections and 77% received antenatal corticosteroids. Upon KMCP admission, median GA, chronological age and hospital stay were 36 weeks, 19 and 17 days, respectively; 55.6% of patients had neonatal sepsis and 66.6% were admitted to Neonatal Intensive Care Unit. Patients had on average 52 days with oxygen, a median of 3200g and 42 weeks GA at oxygen weaning. Median follow-up oxygen saturation was 94% with 0.016-0.5 l/min of oxygen. One-year mortality was 0.2% and attrition 20%. At 6 months, all patients had appropriate growth and 66% were breastfeeding. Multiple regression analysis showed that higher GA, Hb levels, weight gain, and exclusive breastfeeding decreased oxygen requirement whilst invasive ventilation and transfusions had the opposite effect (R2=0.48). Conclusions: In OD preterm infants, there is a close relationship between days of oxygen requirement and GA, mechanical ventilation, Hb levels at discharge, transfusions, exclusive breastfeeding and weight gain. Strict monitoring with established protocols in an ambulatory KMCP allows adequate growth and safe oxygen weaning.