# Caffeine citrate

Drug · id `maternal:caffeine-citrate` · Maternal & Newborn Atlas · release `c7fb95f1d15a7d13` (public)

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Browse, life stage: Newborn  
Browse, care area: Preterm and sick newborns  

## In plain language

A medicine given to babies born early for apnoea of prematurity. In the CAP trial, caffeine given for this reason to very low birth weight babies lowered the share still needing oxygen at 36 weeks of postmenstrual age, which the trial authors call a lower rate of bronchopulmonary dysplasia.

## Technical summary

Drug, level substance. RxCUI 20033 (RxNav name caffeine citrate, term type PIN, a precise ingredient) read 2026-10-15. The one claim on this page is a placebo-controlled trial in infants of 500 to 1250 g with short-term outcomes. It is a result for caffeine given for apnoea of prematurity, not a trial of caffeine to prevent BPD in infants without apnoea. No dose is recorded.

## Claims, with the population each applies to

## Context: Infants with birth weight 500 to 1250 g given caffeine or placebo in the first 10 days (CAP trial)

Recipient: Newborn; Population: 2006 infants with birth weights of 500 to 1250 g, randomly assigned during the first 10 days of life to caffeine or placebo until drug therapy for apnoea of prematurity was no longer needed. Supplemental oxygen at 36 weeks was counted among infants still alive at that postmenstrual age: 963 in the caffeine group and 954 in the placebo group. The registry lists the United States, Australia, Canada, Germany, Israel, the Netherlands, Sweden, Switzerland and the United Kingdom.; Care setting: Multicentre trial; the abstract names no setting; Geography: Nine countries listed by the registry (the abstract names none); Life stage: Very low birth weight infants in the first 10 days of life; short-term outcomes before the first discharge home; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Short-term outcomes were evaluated before the first discharge home; the registry also lists outcomes at 18 months, 5 years and 11 to 12 years, which this record does not cover.

### In the CAP trial, 2006 infants with birth weights of 500 to 1250 g were randomly assigned during the first 10 days of life to caffeine or placebo until treatment for apnoea of prematurity was no longer needed. Among infants alive at a postmenstrual age of 36 weeks, 350 of 963 (36%) assigned to caffeine received supplemental oxygen, against 447 of 954 (47%) assigned to placebo (adjusted odds ratio 0.63; 95% CI 0.52 to 0.76; P&lt;0.001). Positive airway pressure was stopped one week earlier with caffeine (median postmenstrual age 31.0 weeks against 32.0 weeks; P&lt;0.001). Caffeine reduced weight gain temporarily (greatest after two weeks: mean difference -23 g; 95% CI -32 to -13; P&lt;0.001). Rates of death, ultrasonographic signs of brain injury and necrotizing enterocolitis did not differ significantly between the groups. The authors conclude that caffeine therapy for apnoea of prematurity reduces the rate of bronchopulmonary dysplasia in infants with very low birth weight.

- Category: Effect
- Evidence stage: Interventional
- Certainty: Certainty not assessed
- Applies to: Recipient: Newborn; Population: 2006 infants with birth weights of 500 to 1250 g, randomly assigned during the first 10 days of life to caffeine or placebo until drug therapy for apnoea of prematurity was no longer needed. Supplemental oxygen at 36 weeks was counted among infants still alive at that postmenstrual age: 963 in the caffeine group and 954 in the placebo group. The registry lists the United States, Australia, Canada, Germany, Israel, the Netherlands, Sweden, Switzerland and the United Kingdom.; Care setting: Multicentre trial; the abstract names no setting; Geography: Nine countries listed by the registry (the abstract names none); Life stage: Very low birth weight infants in the first 10 days of life; short-term outcomes before the first discharge home; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Short-term outcomes were evaluated before the first discharge home; the registry also lists outcomes at 18 months, 5 years and 11 to 12 years, which this record does not cover.
- Limitations: Only the abstract was read. The result is for short-term outcomes before first discharge; the abstract reports the need for supplemental oxygen at 36 weeks, which the authors call bronchopulmonary dysplasia in their conclusion. Caffeine was given for apnoea of prematurity, so this is a finding about caffeine used for that reason (prevention of BPD in these infants), not about treating established BPD. Longer-term outcomes of the trial are not in this abstract and are not recorded.
- Last checked: 2026-10-15
- Sources:
  1. Supports: Caffeine therapy for apnea of prematurity (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa054065>
     Locator: Abstract, RESULTS sentences 1 to 5 and CONCLUSIONS sentence 1. Retrieved 2026-10-15T13:49:24Z. Source state: Current. Snapshot hash: 257ddaadc90261743da0e865cb298a75f876be42ffac58f97a7ae522901b30f7.
     How it applies: Oxygen need at 36 weeks, airway pressure, weight gain, other outcomes and the conclusion.
  2. Background: Caffeine therapy for apnea of prematurity (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) <https://doi.org/10.1056/NEJMoa054065>
     Locator: Abstract, BACKGROUND sentence 1 and METHODS. Retrieved 2026-10-15T13:49:24Z. Source state: Current. Snapshot hash: 257ddaadc90261743da0e865cb298a75f876be42ffac58f97a7ae522901b30f7.
     How it applies: Population, groups and follow-up.

## Connected pages

- CAP: caffeine given for apnoea of prematurity and the rate of BPD: Bronchopulmonary dysplasia (chronic lung disease of prematurity) (`maternal:bronchopulmonary-dysplasia`) [a claim, not a settled fact; see claim `maternal:claim-cap-caffeine-bpd` and its context]
- Filed under this front: Medicines and vaccines (`maternal:front-medicines-and-vaccines`)
- Contained in: Cafcit (caffeine citrate) (`maternal:cafcit`)
- Investigated in: Caffeine for Apnea of Prematurity (CAP) trial (`maternal:cap-trial`)

## Provenance

Content hash: 72a31ff1a83910bead69508e6d68d0f7392b7e43ebd44f2b80140b6dd2b49d71
Last substantive edit: 2026-10-15
Evidence last checked: 2026-10-15
