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Meta-Analysis
. 2018 Jun;45(2):273-291.
doi: 10.1016/j.clp.2018.01.012. Epub 2018 Mar 7.

Optimizing Caffeine Use and Risk of Bronchopulmonary Dysplasia in Preterm Infants: A Systematic Review, Meta-analysis, and Application of Grading of Recommendations Assessment, Development, and Evaluation Methodology

Mitali Atul Pakvasa  1 , Vivek Saroha  1 , Ravi Mangal Patel  2
Affiliations
Meta-Analysis

Optimizing Caffeine Use and Risk of Bronchopulmonary Dysplasia in Preterm Infants: A Systematic Review, Meta-analysis, and Application of Grading of Recommendations Assessment, Development, and Evaluation Methodology

Mitali Atul Pakvasa et al. Clin Perinatol. 2018 Jun.

Abstract

Caffeine reduces the risk of bronchopulmonary dysplasia (BPD). Optimizing caffeine use could increase therapeutic benefit. We performed a systematic-review and random-effects meta-analysis of studies comparing different timing of initiation and dose of caffeine on the risk of BPD. Earlier initiation, compared to later, was associated with a decreased risk of BPD (5 observational studies; n = 63,049, adjusted OR 0.69; 95% CI 0.64-0.75, GRADE: low quality). High-dose caffeine, compared to standard-dose, was associated with a decreased risk of BPD (3 randomized trials, n = 432, OR 0.65; 95% CI 0.43-0.97; GRADE: low quality). Higher quality evidence is needed to guide optimal caffeine use.

Keywords: Caffeine; Dose; Duration; Infant; Methylxanthine; Neonate; Preterm; Timing.

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