TOPLINE:

Premature infants were discharged on continued caffeine therapy for apnoea in Europe, with 58% of surveyed neonatal units reported this practice at least occasionally; home monitoring was routinely prescribed by 58% of those units, with marked geographic variation seen in monitoring and discontinuation strategies.

METHODOLOGY:

• Researchers conducted a web‑based, three‑part survey among neonatologists across Europe to collect information on current clinical practices related to the discharge of premature infants on caffeine therapy, including planning, home monitoring, and strategies to discontinue the treatment.
• They analysed 125 complete responses from neonatal units across 21 European countries out of 633 neonatal units contacted between July and October 2025.
• Survey questions assessed practices concerning the discharge of premature infants on caffeine therapy, including dosing regimens, criteria for discontinuing caffeine therapy in both hospital and post-discharge settings, and requirements for home monitoring.

TAKEAWAY:

• More than half (58%) of responding units reported discharging premature infants on continued caffeine therapy at least occasionally. Notably, this practice was not reported by any respondents in the UK.
• Most units (73%) used a combination of respiratory stability and postmenstrual age (PMA) to determine when to stop caffeine therapy, with 74% stopping therapy between 34 + 0 and 36 + 6 weeks of PMA and 22% discontinuing therapy between 32 + 0 and 33 + 6 weeks of PMA in stable infants.
• For premature infants discharged on continued caffeine therapy, most units prescribed doses of 5 mg/kg/d (38%), between 5 and 10 mg/kg/d (41%), or 10 mg/kg/d (18%), with once-daily administration being the most commonly used (70%).
• Home monitoring was routinely prescribed by 58% of units for infants discharged on continued caffeine therapy; monitoring requirements and discontinuation strategies varied significantly between regions in Europe (P = .003).

IN PRACTICE:

"[The study] demonstrate wide variation in practises surrounding discharging preterm infants on continued caffeine therapy across Europe," the authors wrote. "Given the importance of the subject, evidence-based guidelines are urgently needed to standardise treatment practises," they added.

"Our study might help design trials addressing the most pressing questions, grounding possible interventions in the existing heterogeneity of clinical care," they concluded.

SOURCE:

This study was led by Martin Kuntz, Adolescent Medicine and Neonatology, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany. It was published online on March 14, 2026, in Acta Paediatrica.

LIMITATIONS:

The modest response rate may have introduced sampling bias and limited representativeness across European neonatal units. Centres discharging premature infants on continued caffeine therapy may be overrepresented in the sample.

DISCLOSURES:

This study did not receive any specific funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.