Administration Time of Caffeine in Preterm Infants: Systematic Review and Meta-analysis

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2024 Jul 2

PMID 38956314

Authors

Gabriela S Trindade

Renato S Procianoy

Victoria Baptista Dos Santos

Alicia Dorneles Dornelles

Rita C Silveira

Affiliations

Soon will be listed here.

Abstract

To assess the ideal time for caffeine administration in preterms, identifying its effects and safety. Study Design: Meta-analysis conducted including preterms <32 weeks GA or BW < 1500 g, comparing caffeine administration time: <24 x ≥24HOL, <48 x ≥48HOL, <72 x ≥72HOL. 18 studies included 76.998 patients. The median age of starting caffeine was the first 24 HOL. In the overall comparisons, there was reduction in patent ductus arteriosus (OR 0.71 [0.55, 0. 92]; low evidence), retinopathy of prematurity (OR 0.71 [0.54, 0.93]; moderate evidence), severe brain injury (OR 0.79 [0.70, 0.91]; moderate evidence), bronchopulmonary dysplasia (BPD) (OR 0.69 [0.59, 0.81]; moderate evidence), composite outcome of BPD or death (OR 0.76 [0.66, 0.88]; moderate evidence). Mortality increase was found (OR 1.20 [1.12, 1.29], very low evidence).Caffeine in the first 24 HOL has benefits in reducing morbidities associated with prematurity. Mortality finding is potentially due to survival bias.

References

Schmidt B, Roberts R, Davis P, Doyle L, Barrington K, Ohlsson A . Caffeine therapy for apnea of prematurity. N Engl J Med. 2006; 354(20):2112-21. DOI: 10.1056/NEJMoa054065. View

Amaro C, Bello J, Jain D, Ramnath A, DUgard C, Vanbuskirk S . Early Caffeine and Weaning from Mechanical Ventilation in Preterm Infants: A Randomized, Placebo-Controlled Trial. J Pediatr. 2018; 196:52-57. DOI: 10.1016/j.jpeds.2018.01.010. View

Davis P, Schmidt B, Roberts R, Doyle L, Asztalos E, Haslam R . Caffeine for Apnea of Prematurity trial: benefits may vary in subgroups. J Pediatr. 2009; 156(3):382-7. DOI: 10.1016/j.jpeds.2009.09.069. View

Dobson N, Patel R, Smith P, Kuehn D, Clark J, Vyas-Read S . Trends in caffeine use and association between clinical outcomes and timing of therapy in very low birth weight infants. J Pediatr. 2014; 164(5):992-998.e3. PMC: 3992195. DOI: 10.1016/j.jpeds.2013.12.025. View

Davis P . When to start and stop caffeine and why respiratory status matters. Semin Fetal Neonatal Med. 2020; 25(6):101175. DOI: 10.1016/j.siny.2020.101175. View

Moschino L, Zivanovic S, Hartley C, Trevisanuto D, Baraldi E, Roehr C . Caffeine in preterm infants: where are we in 2020?. ERJ Open Res. 2020; 6(1). PMC: 7049734. DOI: 10.1183/23120541.00330-2019. View

Elmowafi M, Mohsen N, Nour I, Nasef N . Prophylactic versus therapeutic caffeine for apnea of prematurity: a randomized controlled trial. J Matern Fetal Neonatal Med. 2021; 35(25):6053-6061. DOI: 10.1080/14767058.2021.1904873. View

Wan X, Wang W, Liu J, Tong T . Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol. 2014; 14:135. PMC: 4383202. DOI: 10.1186/1471-2288-14-135. View

Dekker J, Hooper S, van Vonderen J, Witlox R, Lopriore E, Te Pas A . Caffeine to improve breathing effort of preterm infants at birth: a randomized controlled trial. Pediatr Res. 2017; 82(2):290-296. DOI: 10.1038/pr.2017.45. View

10.

Katheria A, Sauberan J, Akotia D, Rich W, Durham J, Finer N . A Pilot Randomized Controlled Trial of Early versus Routine Caffeine in Extremely Premature Infants. Am J Perinatol. 2015; 32(9):879-86. DOI: 10.1055/s-0034-1543981. View

11.

Ye H, Bai L, Yang M, Yang X, Zheng M, Zhong X . A two-center retrospective study: association of early caffeine administration and oxygen radical diseases in neonatology in Chinese preterm neonates. Front Pediatr. 2023; 11:1158286. PMC: 10303785. DOI: 10.3389/fped.2023.1158286. View

12.

Gupte A, Gupta D, Ravichandran S, Ma M, Chouthai N . Effect of early caffeine on neurodevelopmental outcome of very low-birth weight newborns. J Matern Fetal Neonatal Med. 2015; 29(8):1233-7. DOI: 10.3109/14767058.2015.1041493. View

13.

Taha D, Kirkby S, Nawab U, Dysart K, Genen L, Greenspan J . Early caffeine therapy for prevention of bronchopulmonary dysplasia in preterm infants. J Matern Fetal Neonatal Med. 2014; 27(16):1698-702. DOI: 10.3109/14767058.2014.885941. View

14.

Patel R, Leong T, Carlton D, Vyas-Read S . Early caffeine therapy and clinical outcomes in extremely preterm infants. J Perinatol. 2012; 33(2):134-40. DOI: 10.1038/jp.2012.52. View

15.

Lodha A, Seshia M, McMillan D, Barrington K, Yang J, Lee S . Association of early caffeine administration and neonatal outcomes in very preterm neonates. JAMA Pediatr. 2014; 169(1):33-8. DOI: 10.1001/jamapediatrics.2014.2223. View

16.

Hand I, Zaghloul N, Barash L, Parris R, Aden U, Li H . Timing of Caffeine Therapy and Neonatal Outcomes in Preterm Infants: A Retrospective Study. Int J Pediatr. 2016; 2016:9478204. PMC: 4875982. DOI: 10.1155/2016/9478204. View

17.

Szatkowski L, Fateh S, Abramson J, Kwok T, Sharkey D, Budge H . Observational cohort study of use of caffeine in preterm infants and association between early caffeine use and neonatal outcomes. Arch Dis Child Fetal Neonatal Ed. 2023; 108(5):505-510. DOI: 10.1136/archdischild-2022-324919. View

18.

Ozkan H, Cetinkaya M, Cakir S, Saglam O, Koksal N . Effects of Different Onset Times of Early Caffeine Treatment on Mesenteric Tissue Oxygenation and Necrotizing Enterocolitis: A Prospective, Randomized Study. Am J Perinatol. 2021; 40(1):28-34. DOI: 10.1055/s-0041-1727157. View

19.

Patel R, Zimmerman K, Carlton D, Clark R, Benjamin D, Smith P . Early Caffeine Prophylaxis and Risk of Failure of Initial Continuous Positive Airway Pressure in Very Low Birth Weight Infants. J Pediatr. 2017; 190:108-111.e1. PMC: 5690812. DOI: 10.1016/j.jpeds.2017.07.006. View

20.

Borszewska-Kornacka M, Hozejowski R, Rutkowska M, Lauterbach R . Shifting the boundaries for early caffeine initiation in neonatal practice: Results of a prospective, multicenter study on very preterm infants with respiratory distress syndrome. PLoS One. 2017; 12(12):e0189152. PMC: 5738066. DOI: 10.1371/journal.pone.0189152. View