Cochrane · systematic review · CD015462
Caffeine versus other methylxanthines for the prevention and treatment of apnea in preterm infants
Moresco, L, Sjögren, A, Marques, KA, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
NeonatalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
9
No studies
5
Included studies
NR
No studies 5 · 35.7%Ungraded 0 · 0%Very low 6 · 42.9%Low 3 · 21.4%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Caffeine compared to other methylxanthines for the prevention and treatment of apnea in preterm infants
Population: preterm infants
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
All‐cause mortality prior to hospital discharge№ of participants: 396(2 RCTs) Caffeine vs other methylxanthines | RR 1.12 [0.68, 1.84] | NR | Low Downgraded: imprecision |
Moderate to severe neurodevelopmental disability at 18 to 26 months Caffeine vs other methylxanthines | no estimate extracted | NR | No studies |
a) Cerebral palsy Caffeine vs other methylxanthines | no estimate extracted | NR | No studies |
b) Gross motor disability defined as ≥ level 2 according to the GMFCS Caffeine vs other methylxanthines | no estimate extracted | NR | No studies |
c) Developmental delay more than two SDs below population mean on a standardized test of development: cognitive delay № of participants: 79(1 RCT) Caffeine vs other methylxanthines | RR 0.17 [0.02, 1.37] | NR | Very low Downgraded: risk of bias, imprecision |
c) Developmental delay more than two SDs below population mean on a standardized test of development: language delay № of participants: 79(1 RCT) Caffeine vs other methylxanthines | RR 0.76 [0.37, 1.58] | NR | Very low Downgraded: risk of bias, imprecision |
c) Developmental delay more than two SDs below population mean on a standardized test of development: motor delay № of participants: 79(1 RCT) Caffeine vs other methylxanthines | RR 0.5 [0.13, 1.96] | NR | Very low Downgraded: risk of bias, imprecision |
d) Mental development IQ > 2 SD below the mean Caffeine vs other methylxanthines | no estimate extracted | NR | No studies |
e) Visual impairment (vision < 6/60 in both eyes) № of participants: 21(1 RCT) Caffeine vs other methylxanthines | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
f) Hearing impairment (requiring amplification) № of participants: 6(1 RCT) Caffeine vs other methylxanthines | no estimate extracted | NR | Very low Downgraded: risk of bias, imprecision |
Bronchopulmonary dysplasia/chronic lung disease: defined as 28 days of oxygen exposure at 36 weeks' postmenstrual age№ of participants: 481(3 RCTs) Caffeine vs other methylxanthines | RR 1.4 [0.92, 2.11] | NR | Low Downgraded: risk of bias, imprecision |
Side effects (tachycardia, agitation, or feed intolerance) leading to a reduction in dose or withholding of methylxanthines№ of participants: 30(1 RCT) Caffeine vs other methylxanthines | RR 0.17 [0.02, 1.32] | NR | Very low Downgraded: imprecision |
Duration of hospital stay (days) № of participants: 240 (1 RCT) Caffeine vs other methylxanthines | no estimate extracted | NR | Low Downgraded: imprecision |
Seizures (clinically diagnosed) Caffeine vs other methylxanthines | no estimate extracted | NR | No studies |