Safety and efficacy of caffeine use started at different time in preterm infants: a multicenter study in Jiangsu Province, China

Abstract:

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.