Does routine prophylaxis with caffeine prevent bronchopulmonary dysplasia in extremely low birth weight infants?

Abstract

Objective: The objective of the study was to determine the risk of developing bronchopulmonary dysplasia (BPD) in extremely low birth weight (ELBW) infants with and without caffeine prophylaxis. We hypothesized that there would be no difference in the risk of BPD between the two groups. Study Design: This was a comparative, single-center, retrospective cohort study comparing risk of BPD in ELBW infants (≤28-week gestation or ≤1001 g if gestational age [GA] unknown) receiving caffeine for BPD prophylaxis within the first 24 h of life to those with no prophylaxis. Materials and Methods: The risk of developing BPD in infants receiving caffeine for BPD prophylaxis was compared with a matched nonprophylaxis group. BPD was defined as the need for oxygen support at 36-week corrected GA (CGA). Secondary outcomes included total caffeine exposure, average weekly maintenance dose, and length of treatment and duration of mechanical ventilation. Results: One hundred and eight out of 153 infants (71%) received caffeine prophylaxis. The risk of developing BPD at 34–36-week CGA was not significantly different between the two groups (odds ratio [OR]: 0.92, 95% confidence interval [CI]: 0.45–1.84). Infants in the prophylaxis group had higher total caffeine exposure and daily caffeine dose. There was no association between a patient's average daily dose of caffeine and risk of BPD (OR = 1.03, 95% CI: 0.91–1.18;P = 0.62). The duration of caffeine treatment was longer in the nonprophylaxis group. Infants in the prophylaxis group spent fewer days on mechanical ventilator (P = 0.03). Conclusion: The risk of BPD in infants receiving caffeine prophylaxis for BPD prevention was similar to a matched group of infants with no caffeine prophylaxis.