Evaluation Of The Subordinate Efficacy Of Caffeine In The Treatment Of Neonatal Apnea

Objective: To compare the long-term therapeutic effects of caffeine and placebo in treatment of apnea of prematurity(AOP)through systematic review and meta-analysis.Methods: Literatures on AOP treated with caffeine and placebo as well as comparison of early with later effects of caffeine administration published between January 2000 and June 2016 were retrieved from the database,including Pub Med,EMBASE,CNKI and Wan Fang Database and others.Then the clinical quality of trial was assessed using modified Jadad scale,and eligible studies were included for systematic review and meta-analysis with software Stata(version 11.0)through pooling the value of relative risk(RR),odds ratio(OR)and 95% confidence intervals(CI).Results: A total of 11 randomized controlled trials were included.Part one included 5 prospective cohort studies.Meta-analysis indicated that caffeine appeared superior to placebo in reducing the incidences of cognitive disorder(RR=0.887,95% CI 0.813-0.966,P=0.006),cerebral palsy(RR=0.581,95% CI: 0.437-0.774,P=0.001)and patent ductus arteriosus(PDA)(RR=0.598,95% CI: 0.538-0.665,P=0.000).Part two were associated with 6 retrospective cohort studies,which showed early administration with caffeine had significantly reduced the incidences of PDA(OR=0.568,95% CI: 0.362-0.892,P=0.014)and bronchopulmonary dysplasia(OR =0.641,95% CI: 0.517-0.795,P<0.001).Conclusion: Caffeine can effectively reduce the incidences of cognitive disorder,cerebral palsy and PDA in the treatment of AOP.Importantly,early use of caffeine may reduce the morbidity of PDA and bronchopulmonary dysplasia in premature infants with apnea.