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International Journal of Pediatrics
Volume 2016, Article ID 9478204, 6 pages
http://dx.doi.org/10.1155/2016/9478204
Research Article

Timing of Caffeine Therapy and Neonatal Outcomes in Preterm Infants: A Retrospective Study

1Department of Pediatrics/Division of Neonatology, Kings County Hospital, Brooklyn, NY, USA
2Department of Pediatrics, SUNY-Downstate Medical Center, Brooklyn, NY, USA
3Cohen Children’s Hospital at New York-North Shore Health System, Manhasset, NY, USA
4Department of Women’s and Children’s Health, Karolinska Institute, Sweden
5Department of Physiology and Pharmacology, SUNY-Downstate Medical Center, Brooklyn, NY, USA
6Department of Biology, Medgar Evers College, City University of New York, Brooklyn, NY, USA

Received 15 November 2015; Revised 11 March 2016; Accepted 20 April 2016

Academic Editor: Namık Yaşar Özbek

Copyright © 2016 Ivan Hand et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Caffeine is widely used to treat apnea of prematurity. Here, we evaluated the efficacy of early caffeine (1-2 DOL) in decreasing the incidence of adverse neonatal outcomes. Methods. A retrospective cohort was used to compare the neonatal morbidity of 150 preterm neonates with gestational age ≤29 weeks. Infants were divided into 3 groups based on the initiation timing of caffeine therapy; (1) early caffeine (1-2 DOL), (2) late caffeine (3–7 DOL), and (3) very late caffeine (≥8 DOL). Results. The neonatal outcomes of early caffeine were comparable with those of the late caffeine group. Moreover, when comparing the neonatal morbidity of the very late caffeine group with that of the early caffeine group, multivariable logistic regression analyses were performed. We found that the timing of caffeine did not influence the risk of BPD (OR, 0.393; CI, 0.126–1.223; ), but birthweight did (OR, 0.996; CI, 0.993–0.999; ) in these infants. Conclusion. Neonatal outcomes of preterm infants were comparable whether caffeine was administered early or late in the first 7 DOL. The risk of BPD in infants receiving caffeine after 8 DOL was irrespective of delayed treatment with caffeine. Our results clearly demonstrate the need for further studies before caffeine prophylaxis can be universally recommended.