Studies should help define the appropriate therapeutic window for caffeine treatment along with with the mechanisms relating to its beneficial effects on the brain and the lung. Caffeine therapy is a significant advance in newborn care, conferring immediate benefits in preterm neonates. However, in-utero exposure to caffeine is also associated with excess growth, obesity, and cardio-metabolic changes in children. Prenatal caffeine predisposes to intrauterine growth restriction and small growth for gestational age at birth. However, in animal models, exposure to caffeine during pregnancy and lactation adversely affects neuronal development and adult behavior of their offspring. Follow-up studies of the infants in the Caffeine for Apnea of Prematurity trial highlight the long-term safety of caffeine in these infants, especially relating to motor, behavioral, and intelligence skills. Caffeine for apnea of prematurity reduces the incidence of bronchopulmonary dysplasia in very-low-birth-weight infants and improves survival without neurodevelopmental disability at 18–21 months. It is effective in the management of apnea of prematurity in premature infants. Caffeine is the most widely used drug by both adults and children worldwide due to its ability to promote alertness and elevate moods.
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