Caffeine Treatment for Apnea of Prematurity and the Influence on Dose-Dependent Postnatal Weight Gain Observed Over 15 Years.

IF 1.7 Q4 Pharmacology, Toxicology and Pharmaceutics
Roy K Philip, Abu Ismail, Bernadette Murphy, Adnan Mirza, Collette Quinn, Margo Dunworth
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引用次数: 13

Abstract

Background and Aim: To analyze the influence on weight gain of infants exposed to two dosage regimens of oral caffeine citrate (CC) for apnea of prematurity. Methods: Retrospective descriptive observational study of an eligible very low birth weight cohort over a 15-year period in an Irish University hospital. Data were analyzed between two distinct postnatal ages: 14-28 and 29-56 days. Results: During the 15-year study, 457 infants were prescribed caffeine. Among the 14-28-day group, after applying exclusion criteria, 418 infants qualified. Two hundred forty-eight infants received 5 mg/(kg·day) and 170 received 10 mg/(kg·day) of CC. Among the 29-56-day group, 362 infants were identified and after applying exclusions, 332 fulfilled entry criteria [214 on 5 mg/(kg·day) and 118 on 10 mg/(kg·day) regimen]. Baseline characteristics of infants were comparable between groups without statistically significant differences. Mean daily weight gain (MDWG) in grams from day 14 to 28 showed a higher rate of increase for the 5 mg/(kg·day) group compared with the 10 mg/(kg·day) group (17.2 ± 12 g vs. 13.0 ± 10.2 g [p = 0.04]). From day 29 to 56, also MDWG was higher among infants on 5 mg/(kg·day) of CC compared with 10 mg/(kg·day) group (15.6 ± 10.8 g vs. 10.2 ± 9.8 g [p = 0.011]). Conclusion: While a variety of measures are optimized to promote postnatal weight gain of premature infants close to an ideal intrauterine growth curve, not paying sufficient attention to one of the most widely used catabolic agents in neonatology is questionable and warrants vigilance. Additional nutritional measures could be offered to those with prolonged caffeine exposure.

15年来咖啡因治疗早产儿呼吸暂停及其对剂量依赖性产后体重增加的影响
背景与目的:分析两种剂量方案口服枸橼酸咖啡因(CC)治疗早产儿呼吸暂停对婴儿体重增加的影响。方法:回顾性描述性观察研究符合条件的极低出生体重队列在爱尔兰大学医院超过15年的时间。数据分析两个不同的出生年龄:14-28天和29-56天。结果:在15年的研究中,457名婴儿服用了咖啡因。在14-28天组中,应用排除标准后,合格婴儿418例。248名婴儿接受5mg /(kg·d) CC治疗,170名接受10mg /(kg·d) CC治疗。在29-56天组中,362名婴儿被确定,在排除后,332名婴儿符合入组标准[5mg /(kg·d)方案214名,10mg /(kg·d)方案118名]。婴儿的基线特征在两组之间具有可比性,无统计学显著差异。第14 ~ 28天,5 mg/(kg·d)组的平均日增重(mddg)(17.2±12 g vs. 13.0±10.2 g)高于10 mg/(kg·d)组(以克为单位)(p = 0.04)。从第29天到第56天,5 mg/(kg·d) CC组婴儿的MDWG也高于10 mg/(kg·d)组(15.6±10.8 g vs 10.2±9.8 g [p = 0.011])。结论:虽然优化了多种措施来促进早产儿出生后体重增加,使其接近理想的宫内生长曲线,但对新生儿中最广泛使用的分解代谢药物之一缺乏足够的重视是值得怀疑的,值得警惕。对于那些长期摄入咖啡因的人,可以采取额外的营养措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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