It occurs in almost all infants born before 28 weeks of gestation. Because of the many gaps in knowledge, especially as it relates to efficacy and safety, we encourage further basic and clinical studies to provide stronger evidence, not only on its potential beneficial effects but also its side effects.Īpnea of prematurity (AOP) is a common developmental disorder with an incidence that is closely linked to the degree of immaturity at birth. This review summarizes some of the available evidence on caffeine use in this population, its indications and best timing of initiation and discontinuation, appropriate dosing, and some of the possible adverse effects of caffeine administration. Because of these uncertainties, there is a wide variation in caffeine use across institutions. At the same time, there are also many studies in experimental animals and some in preterm infants suggesting potential serious adverse effects from caffeine administration, especially when using higher doses. Besides its clear effectiveness to reduce apnea, the use of caffeine appears to have a wide margin of safety and has been associated with possible beneficial effects on later neurodevelopmental outcome. Caffeine is the only FDA-approved drug for the prevention and treatment of apnea of prematurity. The consequences of apnea of prematurity on neurodevelopment are not well established, but several reports suggest that apnea and hypoxemia episodes may be associated with worse neurological outcome. Apnea of prematurity is a developmental disorder affecting most extremely preterm infants.
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