Observational cohort study of use of caffeine in preterm infants and association between early caffeine use and neonatal outcomes

Szatkowski, Lisa; Fateh, Sheeza; Abramson, Janine; Kwok, T'Ng Chang; Sharkey, Don; Budge, Helen; Ojha, Shalini

Abstract

Objective: To quantify trends in caffeine use in infants born at <32 weeks' gestational age (GA), and to investigate the effects of early vs late caffeine on neonatal outcomes. Study design: Retrospective propensity score matched cohort study using routinely recorded data from the National Neonatal Research Database of infants born at <32 weeks' GA admitted to neonatal units in England and Wales (2012-2020). Results: 89% (58 913/66 081) of infants received caffeine. In 70%, caffeine was started early (on the day of birth or the day after), increasing from 55% in 2012 to 83% in 2020. Caffeine was given for a median (IQR) of 28 (17-43) days starting on day 2 (1-3) and continued up to 34 (33-34) weeks postmenstrual age. In the propensity score matched cohort of 13 045 pairs of infants, the odds of preterm brain injury (early caffeine, 2306/13 045 (17.7%) vs late caffeine, 2528/13 045 (19.4%), OR=0.89 (95% CI 0.84 to 0.95)) and bronchopulmonary dysplasia (BPD) (early caffeine, 4020/13 045 (32.8%) vs late caffeine, 4694/13 045 (37.7%), OR=0.81 (95% CI 0.76 to 0.85)) were lower in the group that received early caffeine compared with those who received it later. Conclusions: Early use of caffeine has increased in England and Wales. This is associated with reduced risks of BPD and preterm brain injury. Randomised trials are needed to find the optimal timing of caffeine use and the groups of infants who will benefit most from early administration of caffeine.

Citation

Szatkowski, L., Fateh, S., Abramson, J., Kwok, T. C., Sharkey, D., Budge, H., & Ojha, S. (2023). Observational cohort study of use of caffeine in preterm infants and association between early caffeine use and neonatal outcomes. Archives of Disease in Childhood. Fetal and Neonatal Edition, 108(5), 505-510. https://doi.org/10.1136/archdischild-2022-324919

• Journal Article Type: Article
• Acceptance Date: Jan 31, 2023
• Online Publication Date: Feb 9, 2023
• Publication Date: Feb 9, 2023
• Deposit Date: Apr 12, 2023
• Publicly Available Date: Apr 12, 2023
• Journal: Archives of Disease in Childhood. Fetal and Neonatal Edition
• Electronic ISSN: 1468-2052
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 108
• Issue: 5
• Article Number: 324919
• Pages: 505-510
• DOI: https://doi.org/10.1136/archdischild-2022-324919
• Keywords: Obstetrics and Gynecology; General Medicine; Pediatrics, Perinatology and Child Health
• Public URL: https://nottingham-repository.worktribe.com/output/17087766
• Publisher URL: https://fn.bmj.com/content/early/2023/02/08/archdischild-2022-324919