Early caffeine therapy and clinical outcomes in extremely preterm infants

J Perinatol. 2013 Feb;33(2):134-40. doi: 10.1038/jp.2012.52. Epub 2012 Apr 26.


Objective: To determine if early caffeine (EC) therapy is associated with decreased bronchopulmonary dysplasia (BPD) or death, decreased treatment of patent ductus arteriosus (PDA), or shortened duration of ventilation.

Study design: In a retrospective cohort of 140 neonates ≤1250 g at birth, infants receiving EC (initiation <3 days of life) were compared with those receiving late caffeine (LC, initiation ≥3 days of life) using logistic regression.

Result: Of infants receiving EC, 25% (21/83) died or developed BPD compared with 53% (30/57) of infants receiving LC (adjusted odds ratio (aOR) 0.26, 95% confidence interval (CI) 0.09 to 0.70; P<0.01). PDA required treatment in 10% of EC infants versus 36% of LC infants (aOR 0.28, 95%CI 0.10 to 0.73; P=0.01). Duration of mechanical ventilation was shorter in infants receiving EC (EC, 6 days; LC, 22 days; P<0.01).

Conclusion: Infants receiving EC therapy had improved neonatal outcomes. Further studies are needed to determine if caffeine prophylaxis should be recommended for preterm infants.

Publication types

  • Comparative Study

MeSH terms

  • Bronchopulmonary Dysplasia / diagnosis
  • Bronchopulmonary Dysplasia / drug therapy*
  • Caffeine / therapeutic use*
  • Cohort Studies
  • Confidence Intervals
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Ductus Arteriosus, Patent / diagnosis
  • Ductus Arteriosus, Patent / drug therapy*
  • Female
  • Follow-Up Studies
  • Hospital Mortality / trends*
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Logistic Models
  • Male
  • Odds Ratio
  • Retrospective Studies
  • Risk Assessment
  • Survival Rate
  • Tertiary Care Centers
  • Treatment Outcome


  • Caffeine