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SYSTEMATIC REVIEW article

Front. Pediatr.
Sec. Pediatric Pulmonology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1528054

Early caffeine therapy decreases bronchopulmonary dysplasia but might increase mortality in preterm infants? a systematic review and meta-analysis

Provisionally accepted
Juan Ma Juan Ma 1Long Chen Long Chen 2Kaihong Mu Kaihong Mu 3Shifang Tang Shifang Tang 3Yuan Shi Yuan Shi 1*
  • 1 Department of Neonatology, Children’s Hospital of Chongqing Medical University, Chongqing, China
  • 2 Department of Neonatology, Women and Children's Hospital of Chongging Medical University (Chongging Health Center for Women and Children), Chongqing, China
  • 3 Department of Pediatrics, SongShan General Hospital, Chongqing, China

The final, formatted version of the article will be published soon.

    Objectives: To assess the effectiveness of early versus late caffeine therapy for bronchopulmonary dysplasia (BPD) in infants.Methods: PubMed, Embase, Web of Science, and Cochrane databases were searched up to October 2024. Studies comparing early and late caffeine therapy for BPD in infants were included. The primary outcomes were the incidence of BPD, severe BPD, and mortality.Results: Eleven studies (1 RCT and 10 cohorts) with 64,749 patients (34,175 early and 30,574 late) were included. Meta-analysis revealed a significantly lower incidence of BPD (OR: 0.67; 95% CI: 0.56, 0.79; P<0.00001) but higher mortality (OR: 1.20; 95% CI: 1.12, 1.29; P<0.00001) in the early group. Subgroup analysis showed a significant difference in BPD incidence in retrospective studies (OR: 0.57; 95% CI: 0.44, 0.74; P<0.0001), but not in prospective studies (OR: 0.84; 95% CI: 0.44, 1.61; P=0.61). No significant difference was observed in severe BPD incidence (OR: 0.89; 95% CI: 0.34, 2.35; P=0.81).Early caffeine therapy may reduce BPD incidence but increase mortality risk in infants. More large-scale, prospective studies are needed to further evaluate the efficacy of early versus late caffeine therapy for BPD.

    Keywords: Caffeine, Bronchopulmonary Dysplasia, Mortality, Meta-analysis, BPD

    Received: 14 Nov 2024; Accepted: 07 Feb 2025.

    Copyright: © 2025 Ma, Chen, Mu, Tang and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yuan Shi, Department of Neonatology, Children’s Hospital of Chongqing Medical University, Chongqing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.