CLINICAL OUTCOMES FOLLOWING EARLY AND LATE CAFFEINE ADMINISTRATION IN VERY PRETERM NEONATES

Abstract

To compare early and late caffeine therapy in very preterm low birth weights newborns for apnoea of prematurity and its effects on various clinical parameters and mortality. Prospective observational study performed on 62 preterm (GA<32weeks and weight<1200g) newborns who randomly received either early caffeine (EC) initiation (<72 hours) or late caffeine (LC) initiation (≥72 hours). The patients were further categorized as ‘survival’ or ‘mortality’ groups. Of 62 patients 38 (61.3%) received EC therapy and 24 (38.7%) received LC therapy. There was 57.8% mortality in the EC and 4.1% in LC group (p value<0.01). EC group had higher incidence of intraventricular hemorrhage (IVH) and shock (p-value<0.01). EC showed better outcome in FiO2 requirement and ICU stay (p-value<0.01). EC was observed to be an independent risk factor for mortality (unadjusted logistic regression OR=31.6, 95% CI=3.9-259, p-value=0.001; adjusted logistic regression OR=69.6, 95% CI=4.6-1059.3, p-value=0.002). EC therapy causes IVH and increased mortality in preterm.