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[Safety and efficacy of caffeine use started at different time in preterm infants: a multicenter study in Jiangsu
1Children's Hospital Affiliated to Nanjing Medical University, Nanjing 210008, China. chengrui351@163.com.
Insights
Early caffeine use in preterm infants (gestational age ≤31 weeks) reduced treatment duration, oxygen needs, and hospital stay without significant adverse effects. This approach is safe and effective for neonates.
Area of Science:
- Neonatal Medicine
- Pharmacology
- Pediatric Critical Care
Background:
- Caffeine is commonly used to treat apnea in preterm infants.
- Optimal timing for initiating caffeine therapy remains under investigation.
Purpose of the Study:
- To evaluate the efficacy and safety of early versus late caffeine administration in preterm infants (≤31 weeks gestational age).
Main Methods:
- Retrospective analysis of 640 preterm infants in China.
- Comparison of clinical data between early (≤72 hours) and late (>72 hours) caffeine use groups.
Main Results:
- Early caffeine use was associated with shorter treatment duration, reduced apnea incidence, shorter oxygen supply time, and decreased hospital stay.
- No significant differences in major neonatal morbidities (e.g., intracranial hemorrhage, necrotizing enterocolitis) or mortality were observed.
- Bronchopulmonary dysplasia incidence and home oxygen therapy rates differed between groups.
Conclusions:
- Early caffeine administration in preterm infants (≤31 weeks) is effective in shortening treatment and hospital stay with minimal adverse effects.
- This strategy offers potential benefits for neonatal intensive care unit management.
Objective:
To study the efficacy and safety of caffeine used in the early (≤72 hours after birth) and late (>72 hours after birth) stage in preterm infants with a gestational age of ≤31 weeks.
Methods:
A retrospective analysis was performed for 640 preterm infants (with a gestational age of ≤31 weeks) who were admitted to the neonatal intensive care unit of eight hospitals in Jiangsu Province, China. Of the 640 preterm infants, 510 were given caffeine in the early stage (≤72 hours after birth; early use group) and 130 were given caffeine in the late stage (>72 hours after birth; late use group). The clinical data were compared between the two groups.
Results:
There were no significant differences in birth weight, Apgar score, sex, gestational age, and age on admission between the two groups (P>0.05). Compared with the late use group, the early use group had a significantly younger age at the beginning and withdrawal of caffeine treatment (P<0.05) and a significantly shorter duration of caffeine treatment (P<0.05). There was no significant difference in respiratory support on admission between the two groups (P>0.05). Compared with the late use group, the early use group had significantly lower incidence rate of apnea (P<0.05) and significantly shorter oxygen supply time and length of hospital stay (P<0.05). There were no significant differences between the two groups in the incidence rates of neonatal intracranial hemorrhage, periventricular leukomalacia, necrotizing enterocolitis, retinopathy of prematurity, and patent ductus arteriosus at discharge and NBNA score at the corrected gestational age of 40 weeks (P>0.05). However, significant differences were found in the incidence of bronchopulmonary dysplasia and the rate of home oxygen therapy, but there was no significant difference in the mortality rate between the two groups (P>0.05).
Conclusions:
Early use of caffeine can shorten the duration of caffeine treatment, oxygen supply time, and length of hospital stay, with little adverse effect, in preterm infants with a gestational age of ≤31 weeks.
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