Caffeine citrate improves outcomes of apnea of prematurity based on gestational ages

Abstract ObjectiveThis study aimed to evaluate the therapeutic effect of caffeine citrate on early premature infants with apnea of prematurity (AOP), and the impact on movement and neurobehavioral development in their early lives.Study designAmongst 397 premature infants whose gestational age (GA) were less than 32 weeks, 172 premature infants were eligible for this study from January 2014 to May 2017. 94 infants received caffeine citrate intervention, 20 infants were given aminophyline and the rest 58 infants didn't received any methylxanthines. According to the incidence of apnea, caffeine using was divided into two situations of therapeutic and preventive administration. The primary clinical outcomes were recorded which included length of stay (LOS), duration of mechanical ventilation, the incidence of complications and outcomes.Results62 cases (66%) were assigned to receive caffeine within 3 days after birth, and 69 cases (74%) received caffeine less than one month. Caffeine could reduce LOS, duration of MV and nasal continues positive airway pressure (nCPAP), the incidence of nosocomial infection and bronchial pulmonary dysplasia (BPD) (p<0.05). There was no significant difference in the incidence of abdominal distension, necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA) and intraventricular hemorrhage (IVH) compared with aminophylline and conservative groups (P >0.05). Caffeine showed different effects on clinical outcomes in early premature infants based on their GAs, and premature infants with larger GA could benefit more from the intervention (p<0.001), and caffeine didn’t affect their early lives in short-term prognosis by follow-up.Conclusion Caffeine can improve AOP clinical outcomes in those premature infants with larger GA, and didn't have side effects on the movement and neurobehavioral development in short-term prognosis.