Duration of Caffeine for Apnea of Prematurity—A Randomized Controlled Trial
Objectives There is sufficient evidence to support use of caffeine therapy for apnea of prematurity, but practices vary widely when it comes to discontinuing therapy. This study was planned to compare ‘recurrence of apnea of prematurity’ (RAP); when 2 protocols were used to stop caffeine therapy. Me...
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| Veröffentlicht in: | Indian journal of pediatrics 2021-12, Vol.88 (12), p.1174-1179 |
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| container_title | Indian journal of pediatrics |
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| creator | Prakash, Raj Pournami, Femitha Prabhakar, Jyothi Nandakumar, Anand Nair, P. M. C. Jain, Naveen |
| description | Objectives
There is sufficient evidence to support use of caffeine therapy for apnea of prematurity, but practices vary widely when it comes to discontinuing therapy. This study was planned to compare ‘recurrence of apnea of prematurity’ (RAP); when 2 protocols were used to stop caffeine therapy.
Methods
Neonates delivered at 26–32 wk gestation on caffeine therapy for apnea of prematurity were randomized into 2 groups: Group 1—caffeine stopped at 7 d apnea-free period, and Group 2—continued for a prefixed period till at least 34 wk postmenstrual age (PMA). Proportion of infants in each group with RAP were analyzed.
Results
Each group consisted of 60 infants. Proportion of infants in each group with RAP, were not different (15%
vs
13%); odds ratio (OR) 0.87; 95% confidence interval (CI) (0.31–2.43). Caffeine could be stopped earlier (33
vs
34 wk PMA); and cumulative duration of therapy was lesser (19.5
vs
33 d) when stopped at 7 d apnea-free period. Other studied outcomes were similar between the two groups.
Conclusions
Mandatorily continuing caffeine therapy up to 34 wk PMA in select preterm groups does not seem to decrease risk of recurrence of apnea. Larger trials that specifically study extremely preterm infants are required to make robust recommendations on when to stop therapy.
Clinical Trials Registry of India no
CTRI/2016/12/007559.
http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=14195&EncHid=&modid=&compid=%27,%2714195det%27 |
| doi_str_mv | 10.1007/s12098-021-03659-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2493003094</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2493003094</sourcerecordid><originalsourceid>FETCH-LOGICAL-c347t-4494af8953de89a936fe815c4a8aad5e8ad614a252ac3993a1a5a204150c1e3f3</originalsourceid><addsrcrecordid>eNp9kE1OwzAQhS0EoqVwARYoSzaB8W_jZVV-pQoQKmtrSGyUKomLnSzKikNwAM7CUTgJKQWWrOZp5r0nzUfIIYUTCjA-jZSBzlJgNAWupE5XW2QIeszTsdJ8u9dAdSqFVAOyF-MCgGlQepcMOFdMKiWH5OasC9iWvkm8S6bonC0bmzgfksmysbje3gVbY9uFsl19vr5NPt7vsSl8Xb7YIpn6pg2-qno5DyVW-2THYRXtwc8ckYeL8_n0Kp3dXl5PJ7M052LcpkJogS7Tkhc206i5cjajMheYIRbSZlgoKpBJhjnXmiNFiQwElZBTyx0fkeNN7zL4587G1tRlzG1VYWN9Fw0TmgNw0KK3so01Dz7GYJ1ZhrLGsDIUzJqj2XA0PUfzzdGs-tDRT3_3WNviL_ILrjfwjSH2p-bJBrPwXWj6n_-r_QIYHn_w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2493003094</pqid></control><display><type>article</type><title>Duration of Caffeine for Apnea of Prematurity—A Randomized Controlled Trial</title><source>SpringerLink Journals - AutoHoldings</source><creator>Prakash, Raj ; Pournami, Femitha ; Prabhakar, Jyothi ; Nandakumar, Anand ; Nair, P. M. C. ; Jain, Naveen</creator><creatorcontrib>Prakash, Raj ; Pournami, Femitha ; Prabhakar, Jyothi ; Nandakumar, Anand ; Nair, P. M. C. ; Jain, Naveen</creatorcontrib><description>Objectives
There is sufficient evidence to support use of caffeine therapy for apnea of prematurity, but practices vary widely when it comes to discontinuing therapy. This study was planned to compare ‘recurrence of apnea of prematurity’ (RAP); when 2 protocols were used to stop caffeine therapy.
Methods
Neonates delivered at 26–32 wk gestation on caffeine therapy for apnea of prematurity were randomized into 2 groups: Group 1—caffeine stopped at 7 d apnea-free period, and Group 2—continued for a prefixed period till at least 34 wk postmenstrual age (PMA). Proportion of infants in each group with RAP were analyzed.
Results
Each group consisted of 60 infants. Proportion of infants in each group with RAP, were not different (15%
vs
13%); odds ratio (OR) 0.87; 95% confidence interval (CI) (0.31–2.43). Caffeine could be stopped earlier (33
vs
34 wk PMA); and cumulative duration of therapy was lesser (19.5
vs
33 d) when stopped at 7 d apnea-free period. Other studied outcomes were similar between the two groups.
Conclusions
Mandatorily continuing caffeine therapy up to 34 wk PMA in select preterm groups does not seem to decrease risk of recurrence of apnea. Larger trials that specifically study extremely preterm infants are required to make robust recommendations on when to stop therapy.
Clinical Trials Registry of India no
CTRI/2016/12/007559.
http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=14195&EncHid=&modid=&compid=%27,%2714195det%27</description><identifier>ISSN: 0019-5456</identifier><identifier>EISSN: 0973-7693</identifier><identifier>DOI: 10.1007/s12098-021-03659-y</identifier><identifier>PMID: 33625665</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Gynecology ; Medicine ; Medicine & Public Health ; Original Article ; Pediatrics</subject><ispartof>Indian journal of pediatrics, 2021-12, Vol.88 (12), p.1174-1179</ispartof><rights>Dr. K C Chaudhuri Foundation 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c347t-4494af8953de89a936fe815c4a8aad5e8ad614a252ac3993a1a5a204150c1e3f3</citedby><cites>FETCH-LOGICAL-c347t-4494af8953de89a936fe815c4a8aad5e8ad614a252ac3993a1a5a204150c1e3f3</cites><orcidid>0000-0002-2921-6003</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12098-021-03659-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12098-021-03659-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33625665$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prakash, Raj</creatorcontrib><creatorcontrib>Pournami, Femitha</creatorcontrib><creatorcontrib>Prabhakar, Jyothi</creatorcontrib><creatorcontrib>Nandakumar, Anand</creatorcontrib><creatorcontrib>Nair, P. M. C.</creatorcontrib><creatorcontrib>Jain, Naveen</creatorcontrib><title>Duration of Caffeine for Apnea of Prematurity—A Randomized Controlled Trial</title><title>Indian journal of pediatrics</title><addtitle>Indian J Pediatr</addtitle><addtitle>Indian J Pediatr</addtitle><description>Objectives
There is sufficient evidence to support use of caffeine therapy for apnea of prematurity, but practices vary widely when it comes to discontinuing therapy. This study was planned to compare ‘recurrence of apnea of prematurity’ (RAP); when 2 protocols were used to stop caffeine therapy.
Methods
Neonates delivered at 26–32 wk gestation on caffeine therapy for apnea of prematurity were randomized into 2 groups: Group 1—caffeine stopped at 7 d apnea-free period, and Group 2—continued for a prefixed period till at least 34 wk postmenstrual age (PMA). Proportion of infants in each group with RAP were analyzed.
Results
Each group consisted of 60 infants. Proportion of infants in each group with RAP, were not different (15%
vs
13%); odds ratio (OR) 0.87; 95% confidence interval (CI) (0.31–2.43). Caffeine could be stopped earlier (33
vs
34 wk PMA); and cumulative duration of therapy was lesser (19.5
vs
33 d) when stopped at 7 d apnea-free period. Other studied outcomes were similar between the two groups.
Conclusions
Mandatorily continuing caffeine therapy up to 34 wk PMA in select preterm groups does not seem to decrease risk of recurrence of apnea. Larger trials that specifically study extremely preterm infants are required to make robust recommendations on when to stop therapy.
Clinical Trials Registry of India no
CTRI/2016/12/007559.
http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=14195&EncHid=&modid=&compid=%27,%2714195det%27</description><subject>Gynecology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Pediatrics</subject><issn>0019-5456</issn><issn>0973-7693</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kE1OwzAQhS0EoqVwARYoSzaB8W_jZVV-pQoQKmtrSGyUKomLnSzKikNwAM7CUTgJKQWWrOZp5r0nzUfIIYUTCjA-jZSBzlJgNAWupE5XW2QIeszTsdJ8u9dAdSqFVAOyF-MCgGlQepcMOFdMKiWH5OasC9iWvkm8S6bonC0bmzgfksmysbje3gVbY9uFsl19vr5NPt7vsSl8Xb7YIpn6pg2-qno5DyVW-2THYRXtwc8ckYeL8_n0Kp3dXl5PJ7M052LcpkJogS7Tkhc206i5cjajMheYIRbSZlgoKpBJhjnXmiNFiQwElZBTyx0fkeNN7zL4587G1tRlzG1VYWN9Fw0TmgNw0KK3so01Dz7GYJ1ZhrLGsDIUzJqj2XA0PUfzzdGs-tDRT3_3WNviL_ILrjfwjSH2p-bJBrPwXWj6n_-r_QIYHn_w</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Prakash, Raj</creator><creator>Pournami, Femitha</creator><creator>Prabhakar, Jyothi</creator><creator>Nandakumar, Anand</creator><creator>Nair, P. M. C.</creator><creator>Jain, Naveen</creator><general>Springer India</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2921-6003</orcidid></search><sort><creationdate>20211201</creationdate><title>Duration of Caffeine for Apnea of Prematurity—A Randomized Controlled Trial</title><author>Prakash, Raj ; Pournami, Femitha ; Prabhakar, Jyothi ; Nandakumar, Anand ; Nair, P. M. C. ; Jain, Naveen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c347t-4494af8953de89a936fe815c4a8aad5e8ad614a252ac3993a1a5a204150c1e3f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Gynecology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Pediatrics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Prakash, Raj</creatorcontrib><creatorcontrib>Pournami, Femitha</creatorcontrib><creatorcontrib>Prabhakar, Jyothi</creatorcontrib><creatorcontrib>Nandakumar, Anand</creatorcontrib><creatorcontrib>Nair, P. M. C.</creatorcontrib><creatorcontrib>Jain, Naveen</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Indian journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prakash, Raj</au><au>Pournami, Femitha</au><au>Prabhakar, Jyothi</au><au>Nandakumar, Anand</au><au>Nair, P. M. C.</au><au>Jain, Naveen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Duration of Caffeine for Apnea of Prematurity—A Randomized Controlled Trial</atitle><jtitle>Indian journal of pediatrics</jtitle><stitle>Indian J Pediatr</stitle><addtitle>Indian J Pediatr</addtitle><date>2021-12-01</date><risdate>2021</risdate><volume>88</volume><issue>12</issue><spage>1174</spage><epage>1179</epage><pages>1174-1179</pages><issn>0019-5456</issn><eissn>0973-7693</eissn><abstract>Objectives
There is sufficient evidence to support use of caffeine therapy for apnea of prematurity, but practices vary widely when it comes to discontinuing therapy. This study was planned to compare ‘recurrence of apnea of prematurity’ (RAP); when 2 protocols were used to stop caffeine therapy.
Methods
Neonates delivered at 26–32 wk gestation on caffeine therapy for apnea of prematurity were randomized into 2 groups: Group 1—caffeine stopped at 7 d apnea-free period, and Group 2—continued for a prefixed period till at least 34 wk postmenstrual age (PMA). Proportion of infants in each group with RAP were analyzed.
Results
Each group consisted of 60 infants. Proportion of infants in each group with RAP, were not different (15%
vs
13%); odds ratio (OR) 0.87; 95% confidence interval (CI) (0.31–2.43). Caffeine could be stopped earlier (33
vs
34 wk PMA); and cumulative duration of therapy was lesser (19.5
vs
33 d) when stopped at 7 d apnea-free period. Other studied outcomes were similar between the two groups.
Conclusions
Mandatorily continuing caffeine therapy up to 34 wk PMA in select preterm groups does not seem to decrease risk of recurrence of apnea. Larger trials that specifically study extremely preterm infants are required to make robust recommendations on when to stop therapy.
Clinical Trials Registry of India no
CTRI/2016/12/007559.
http://ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=14195&EncHid=&modid=&compid=%27,%2714195det%27</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>33625665</pmid><doi>10.1007/s12098-021-03659-y</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-2921-6003</orcidid></addata></record> |
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| subjects | Gynecology Medicine Medicine & Public Health Original Article Pediatrics |
| title | Duration of Caffeine for Apnea of Prematurity—A Randomized Controlled Trial |
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