Caffeine for apnea and prevention of neurodevelopmental impairment in preterm infants: systematic review and meta-analysis.
Elizabeth Anne OliphantSara M HanningChristopher Joel Dorman McKinlayJane Marie AlsweilerPublished in: Journal of perinatology : official journal of the California Perinatal Association (2024)
This systematic review and meta-analysis evaluated the evidence for dose and effectiveness of caffeine in preterm infants. MEDLINE, EMBASE, CINHAL Plus, CENTRAL, and trial databases were searched to July 2022 for trials randomizing preterm infants to caffeine vs. placebo/no treatment, or low (≤10 mg·kg -1 ) vs. high dose (>10 mg·kg -1 caffeine citrate equivalent). Two researchers extracted data and assessed risk of bias using RoB; GRADE evaluation was completed by all authors. Meta-analysis of 15 studies (3530 infants) was performed in REVMAN across four epochs: neonatal/infant (birth-1 year), early childhood (1-5 years), middle childhood (6-11 years) and adolescence (12-19 years). Caffeine reduced apnea (RR 0.59; 95%CI 0.46,0.75; very low certainty) and bronchopulmonary dysplasia (0.77; 0.69,0.86; moderate certainty), with higher doses more effective. Caffeine had no effect on neurocognitive impairment in early childhood but possible benefit on motor function in middle childhood (0.72; 0.57,0.91; moderate certainty). The optimal dose remains unknown; further long-term studies, are needed.
Keyphrases
- preterm infants
- low birth weight
- high dose
- obstructive sleep apnea
- randomized controlled trial
- depressive symptoms
- low dose
- high intensity
- clinical trial
- phase iii
- big data
- bipolar disorder
- electronic health record
- study protocol
- early life
- stem cell transplantation
- pregnant women
- double blind
- positive airway pressure
- congenital heart disease
- data analysis