Efficacy and Safety of Caffeine for Preterm Infants with Apnea According to Birth Weight

Abstract

Apnea of prematurity is one of the most common problems in preterm and low birth weight infants, and it is reported to be more likely to occur in infants of lower gestational age and lower birth weight. The present study investigated the efficacy and safety of caffeine according to weight, based on birth weight. We defined preterm infants with birth weights of < 1,000 g, 1,000 g to < 1,500 g, and 1,500 g to < 2,500 g as the extremely low birth weight (ELBW), very low birth weight (VLBW), and low birth weight (LBW) groups, respectively. There was a significant difference among the three groups in the rate of improvement of apnea attacks from days 1 to 10 of administration. The percentage of cases that showed “improvement” on each day tended to be higher in the LBW group. The incidence of adverse events was 100％ in the ELBW group, 90.9％ in the VLBW group, and 64.7％ in the LBW group (P < 0.001). However, regarding adverse events that were suspected to have been caused by caffeine or events that required dose reduction or discontinuation of caffeine due to adverse events, there were no significant differences among the three groups in any of the items that were investigated. These results suggest that the greater the birth weight, the more likely effects of treatment will occur, and that although careful administration is required, the administration of caffeine to infants of lower birth weight may be feasible.