Effect Of Early Caffeine Therapy On Weight Gain In Very Preterm Infants

Abstract Background: Premature infants were observed to have poor weight gain for the first 3 weeks after initiating caffeine therapy. The practical impact of this adverse effect in the era of prophylactic (early) caffeine therapy in very preterm infants have not been analyzed well. Methods: A retrospective cohort study was conducted including preterm infants born at < 31 weeks gestation between June 2013 and June 2016. Infants were divided into 2 groups based on the timing of caffeine initiation: less than the 48 hours after birth (early) and 48 or more hours after birth (late). The outcome was weight in grams at the end of 3rd week of life. Independent t-test and repeated-measures analysis of covariance (ANCOVA) were used for analysis. Results: Thirty-nine (84.6%) out of 46 infants born < 31 weeks gestation with a birth weight < 1250 grams were included in the study. Of the 39 infants, 22 received early caffeine therapy and 17 received late caffeine therapy. On comparing the weight at 3 weeks of age between the two groups, the early caffeine group had a significantly better weight gain with a mean weight at 3 weeks being 1140 grams vs 985 grams (p=0.03). Conclusion: In very preterm infants, early caffeine therapy was associated with better weight gain in the first 3 weeks of life.