# Clinical efficacy of different maintenance doses of caffeine citrate in the treatment of apnea of prematurity

## TL;DR

This study compares low and high doses of caffeine citrate for treating apnea in premature infants, finding higher doses improve outcomes without increasing costs.

## Contribution

The study demonstrates that higher caffeine citrate doses reduce apnea events and improve long-term development in preterm infants.

## Key findings

- High-dose caffeine citrate reduces bronchopulmonary dysplasia and periventricular leukomalacia in preterm infants.
- Higher caffeine doses improve motor and mental development scores at 12 months without increasing hospitalization costs.
- No significant differences in short-term apnea events or weaning success between low and high doses.

## Abstract

To investigate the efficacy and adverse reactions of caffeine citrate in the treatment of primary apnea of prematurity(AOP) and its effect on the long-term development of preterm infants.

This was a retrospective study. One hundred and forty six infants with AOP treated in the Neonatal Department of Second People’s Hospital of Changzhou Affiliated to Nanjing Medical University between December 2019 and December 2023 were divided into the low-dose group (5mg/kg) and the high-dose group (10 mg/kg) according to the maintenance doses of caffeine, with 73 patients each group. Efficacy, complications, adverse reactions, total hospitalization cost and long-term development of the two groups of patients were retrospectively compared.

Short-term efficacy: No statistically significant differences in the number of apnea events, assisted ventilation duration, oxygen inhalation duration, and weaning success rate were observed between the two groups (P<0.05). The incidences of bronchopulmonary dysplasia (BPD) (P=0.012) and periventricular leukomalacia (PVL) (P=0.005) in the high-dose group were decreased compared with those in the low-dose group, with statistically significant differences. Long-term efficacy: the motor and mental development scores at 12 months of age in the high-dose group were increased compared with those in the low-dose group (P<0.05); and cost-effect analysis: there was no significant difference in the total hospitalization cost between the two group (P>0.05).

High maintenance dose of citrate caffeine in the treatment of AOP significantly reduces the number of apnea events, oxygen inhalation duration, the incidence of BPD and PVL, and positively affects the long-term neurological and motor development, without a significant increase in the hospitalization cost.