Association of Early Caffeine Therapy with Risk Reduction of Moderate-to-Severe Bronchopulmonary Dysplasia in Preterm Infants

Objective: Bronchopulmonary dysplasia (BPD) remains a significant complication in preterm infants.This study aimed to assess the effectiveness of early caffeine (EC) administration within 24 hours of birth in preventing BPD in preterm infants.Methods: This retrospective analysis included preterm infants (<32 weeks of gestation or <1,500 g birth weight) who received caffeine therapy at Wonju Severance Christian Hospital between September 2017 and April 2024.The participants were divided into 2 groups: the EC group (within the first 24 hours after birth) and late caffeine (LC) group (after 24 hours).Primary outcomes included the incidence of overall and moderate-to-severe BPD.Secondary outcomes included duration of respiratory support and other neonatal complications.Results: Among 161 infants (EC, 65; LC, 96), the overall incidence of BPD did not differ between the groups (52.3% vs. 55.2%,P=0.717).The incidence of moderate-to-severe BPD was significantly lower in the EC group (10.8%) than that in the LC group (27.1%), with an adjusted odds ratio of 0.26 (95% confidence interval, 0.09-0.77;P=0.012).No significant differences were found in the duration of invasive (P=0.293) or non-invasive respiratory support (P=0.373).The incidence of other neonatal complications was comparable between the groups.Conclusion: EC therapy, initiated within 24 hours of birth, significantly lowered the incidence and risk of moderate-to-severe BPD in infants born at <32 weeks of gestation or with a birth weight <1,500 g.EC therapy should be considered a preventive strategy for reducing BPD severity.