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Caffeine Therapy Reduces Severe Retinopathy of Prematurity in Neonates with Gestational Age between 23 and 28 Weeks
Yuki Otsuka1, Futoshi Taketani1, Miou Hirose1
1Department of Ophthalmology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki City, Hyogo, Japan.
Purpose:
To investigate the association of caffeine citrate therapy with the onset and exacerbation of retinopathy of prematurity (ROP).
Design:
A retrospective observational cohort study.
Participants:
Preterm neonates born at Hyogo Prefectural Amagasaki General Medical Center between January 2018 and December 2023 were included.
Methods:
Data on maternal (age; comorbid hypertensive disorders of pregnancy and gestational diabetes mellitus; fetal growth restriction; and cesarean section) and neonatal (sex; gestational age; birth weight; zone at initial examination; Apgar scores; respiratory distress syndrome; chronic lung disease; tracheal intubation; duration of tracheal intubation; duration of oxygen therapy; and caffeine therapy) risk factors for ROP were collected from medical records.
Main Outcome Measures:
Retinopathy of prematurity onset and severe ROP were defined as stage ≥1 and stage ≥3 during the course of follow-up, respectively. The association between caffeine therapy and the onset of any ROP and severe ROP was investigated.
Results:
Among 202 neonates included in the current study, 94 (46.5%) developed any ROP (stage ≥1) during the observational period. Only the zone at initial examination affected the onset of any ROP (P < 0.01). However, in 115 neonates born at <32 weeks gestational age and with <1500 g birth weight, larger zones at baseline and caffeine treatment were associated with decreased severe ROP (P = 0.017 and P < 0.01, respectively). Additionally, in 54 neonates with gestational age between 23 and 28 weeks, only caffeine therapy was associated with decreased development of severe ROP (P < 0.01). All 4 neonates with gestational age <23 weeks progressed to severe ROP despite caffeine therapy.
Conclusions:
Caffeine therapy may be a potential treatment strategy to prevent the progression of severe ROP in neonates born between 23 and 28 weeks' gestational age.
Financial Disclosures:
The authors have no proprietary or commercial interest in any materials discussed in this article.
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