Effect of prophylactic caffeine in the treatment of apnea in
very low birth weight infants: a meta-analysis
Objective: The purpose of this meta-analysis is to investigate
the effect of prophylactic caffeine use in the treatment of apnea and
other clinic outcomes in very low birth weight
infants.
Methods: From inception to 20 May 2022, PubMed, Embase, Web of
Science, Scopus, EBSCO, CNKI, and Cochrane databases were systematically
searched. The meta-analysis was carried out using STATA and RevMan
software.
Results : Eleven randomized controlled trials including a total
of 4375 very low birth weight infants were evaluated. The pooled
demonstrated that prophylactic caffeine use was linked with a
significantly lower probability of AOP (OR 0.31, 95%CI: 0.19-0.49,P< 0.001), duration of mechanical ventilation, and
oxygen therapy when compared to control group. It also reduced the
incidence of BPD (OR 0.62, 95%CI: 0.54-0.71, P< 0.001),
PDA (OR 0.49, 95%CI: 0.30-0.80, P =0.005) and ROP (OR 0.76,
95%CI: 0.65-0.90, P =0.001), without raising the risk of NEC, IVH
and death before hospital discharge (P >0.05).
Conclusion : This meta-analysis confirmed the beneficial effects
of prophylactic caffeine for preventing apnea of prematurity as well as
for improving clinical outcomes. However, further research is needed
before recommending widespread use of caffeine as a prophylactic
treatment in the management of all preterm infants.
Keywords: apnea of prematurity; caffeine; very low birth weight
infants; meta-analysis
Abbreviations : AOP: apnea of prematurity; BPD: bronchopulmonary
dysplasia; PDA: patent ductus arteriosus; ROP: retinopathy of
prematurity; NEC: Necrotizing enterocolitis; IVH: intraventricular
hemorrhage