Dose-Dependent Effects of Caffeine Citrate in Preterm Infants: A Retrospective Analysis of Weight Gain and Cardiac Outcomes

Objective: A xanthine, caffeine citrate (CC), increases the metabolic rate with the release of catecholamine and affects weight gain in these patients in the first days. The cardiovascular system increases cardiac output and average arterial blood pressure by increasing heart rate, cardiac contractility, and stroke volume. This study investigated the effects of 5 and 10 mg/kg/day doses of CC on early postnatal weight gain velocity, discharge weight percentile, and cardiac function parameters in preterm infants.Methods: Neonates who underwent CC-therapy between January 2020 and April 2023 and were ≤34 weeks gestation were included in this retrospective analysis. Twenty-three patients were given 5 mg/kg maintenance CC (group 1). Twenty-three patients were given 10 mg/kg maintenance CC (group 2). The groups were compared in terms of demographic data, complications of prematurity (RDS, BPD, NEC, IVH, ROP, PDA), type and duration of respiratory support, time to birth weight, time to total enteral nutrition, discharge weight percentile, and echocardiography (Echo) findings. Data for groups 1 and 2 were examined independently.Results: The study included 46 neonates. Patients in group-1 (11± 6.1 day) achieved their birth weight for a statistically significant shorter period compared to group-2 (15± 5 day) (p <.05). The groups did not differ in any way regarding time to transition to full enteral nutrition, discharge weight percentile, discharge time, echocardiographic results, premature complication, type and duration of respiratory support.Conclusion: Babies receiving CC at a dose of 5 mg/kg/day achieved their birth weight in a shorter time than those receiving 10 mg/kg/day. Both dosage regimens have similar safety in terms of side effects, weight gain after the first week, and cardiological aspects.