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. 2018 Jan 22;18(1):9.
doi: 10.1186/s12887-017-0978-6.

Caffeine is a risk factor for osteopenia of prematurity in preterm infants: a cohort study

Ebtihal Ali  1   2 , Cheryl Rockman-Greenberg  3   4 , Michael Moffatt  5   3   4 , Michael Narvey  3   4 , Martin Reed  6 , Depeng Jiang  5
Affiliations

Caffeine is a risk factor for osteopenia of prematurity in preterm infants: a cohort study

Ebtihal Ali et al. BMC Pediatr. .

Abstract

Background: Caffeine, the most commonly used medication in Neonatal Intensive Care Units, has calciuric and osteoclastogenic effects.

Methods: To examine the association between the cumulative dose and duration of therapy of caffeine and osteopenia of prematurity, a retrospective cohort study was conducted including premature infants less than 31 weeks and birth weight less than 1500 g. Osteopenia of prematurity was evaluated using chest X-rays on a biweekly basis over 12 weeks of hospitalization.

Results: The cohort included 109 infants. 51% had osteopenia of prematurity and 8% had spontaneous rib fractures. Using the generalized linear mixed model, caffeine dose and duration of caffeine therapy showed a strong association with osteopenia of prematurity. Steroids and vitamin D were also significantly correlated with osteopenia of prematurity while diuretic use did not show a statistically significant effect.

Conclusion: The cumulative dose and duration of therapy of caffeine, as well as steroid are associated with osteopenia of prematurity in this cohort. Future studies are needed to confirm these findings and determine the lowest dose of caffeine needed to treat effectively apnea of prematurity.

Keywords: Caffeine; Metabolic bone disease; Osteopenia of prematurity; Premature infants.

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Conflict of interest statement

Ethics approval and consent to participate

The study was approved by the Health Research Ethics Board (HREB) at University of Manitoba number# H2013: 231, and the Health Sciences Center Research Impact Approval from the Health Science Center. Number# RI2013: 088. The included data were retrospective data from medical records and did not include any identifying information. Consent to participate is not applicable for this study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Probability of OP with increasing caffeine dosage at 25 weeks and at 30 weeks gestational age based on the logistic model
Fig. 2
Fig. 2
Probability of OP with prolonged caffeine use based on the logistic model
Fig. 3
Fig. 3
Probability of OP with same Caffeine dosage at 25 weeks and 30 weeks gestational age over the weeks of treatment based on the logistic model
See this image and copyright information in PMC

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