Early caffeine boosts neurodevelopmental outcomes in preterm infants

  • Pediatrics

  • curated by Susan London
  • Clinical Essentials
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Takeaway

  • Compared with counterparts given caffeine therapy more than 2 days after birth, preterm infants given caffeine therapy within 2 days of birth had reduced odds of significant neurodevelopmental impairment at 18-24 months' corrected age.

Why this matters

  • Early caffeine therapy reduces rates of bronchopulmonary dysplasia, patent ductus arteriosus, and death in preterm infants, but the effect on neurodevelopment is unknown.

Key results

  • Compared with the late-caffeine group, the early-caffeine group was less likely to have:
    • Significant neurodevelopmental impairment (aOR, 0.68; 95% CI, 0.50-0.94).
    • Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) cognitive score
  • In propensity score-based matched-pair analyses, the early-caffeine was group less likely to have:
    • Cerebral palsy (aOR, 0.56; 95% CI, 0.32-0.98).
    • Hearing impairment (aOR, 0.56; 95% CI, 0.36-0.89).

Study design

  • Canadian multicenter retrospective cohort study, infants
  • 1545 early caffeine therapy (≤2 days after birth).
  • 563 late caffeine therapy (>2 days after birth).
  • Main outcome: significant neurodevelopmental impairment (≥1 of cerebral palsy, Bayley-III composite score
  • Funding: None.
  • Limitations

    • Lacks of established caffeine therapy guidelines across centers.
    • Attrition bias.

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