Abstract
Objectives
Over half of all preterm neonates started on conventional maintenance-dose caffeine therapy require dose escalation. This study aimed to determine the predictors of failure of conventional maintenance-dose caffeine therapy for apnea of prematurity, which may guide individualized dosing regimens.Methods
In this ambispective cohort study, the authors enrolled neonates Results
A total of 164 neonates (70 prospective, 94 retrospective) were enrolled (gestation 28.7 ± 1.8 wk). Failure occurred in 94 (57%; 95% CI 49-65) neonates. Only gestation independently predicted caffeine failure on multivariable analysis; each one-week increase in gestation nearly halved the odds of treatment failure (aOR: 0.55; 95% CI 0.41-0.72). Neonates with gestation Conclusions
In neonates below 32 wk gestation, lower gestation predicts failure of conventional-dose caffeine therapy. Higher initial maintenance doses warrant further exploration in neonates below 28 wk.