Association of caffeine citrate administration with necrotising enterocolitis in infants < 32 weeks' gestation: a retrospective cohort study.
Early caffeine citrate use linked to lower surgical necrotising enterocolitis in preterm infants
Association of caffeine citrate administration with necrotising enterocolitis in infants < 32 weeks' gestation: a retrospective cohort study.
To examine the association between caffeine citrate administration and necrotising enterocolitis (necrotising enterocolitis) in very preterm infants (very preterm infants).
Level III neonatal intensive care units participating in the Chinese Neonatal Network.
early caffeine citrate lowered odds of needing surgery for necrotising enterocolitis
Among 36 514 who received at least one dose of caffeine citrate, 2315 (6.3%) developed necrotising enterocolitis (≥stage IIA) and 849 (2.3%) experienced surgical necrotising enterocolitis.
Among 9110 very preterm infants without caffeine exposure, 544 (6.0%) developed necrotising enterocolitis (≥stage IIA) and 263 (2.9%) experienced surgical necrotising enterocolitis.
In subgroup analysis, caffeine citrate administration was associated with a reduction in the incidence of necrotising enterocolitis (≥stage IIA) among very preterm infants receiving invasive ventilation at admission (aOR, 0.8; 95% CI 0.67 to 0.94; aAR, -2.04; 95% CI -3.82 to -0.25) and vasopressors before necrotising enterocolitis occurred (aOR, 0.64; 95% CI 0.52 to 0.78; aAR, -5.17; 95% CI -7.94 to -2.39).
While the incidence of necrotising enterocolitis (≥stage IIA) in very preterm infants has not been affected by caffeine citrate, early administration (within 72 hours after birth) was associated with a reduced incidence of surgical necrotising enterocolitis.
Furthermore, among very preterm infants who received invasive ventilation at admission and vasopressors, the administration of caffeine citrate was potentially correlated with a decreased occurrence of necrotising enterocolitis (≥stage IIA).