Discharging Preterm Infants on Caffeine-Practise Variation Across Europe: Results of a Cross-Sectional Survey.

AIM: Caffeine is the mainstay of treatment for apnea of prematurity, yet the optimal strategy and timing for discontinuation remain undefined. Marked inter-centre variation in the practise of discharging preterm infants home on caffeine therapy has been reported. We aimed to map current practises in Europe concerning discharge of preterm infants on caffeine therapy, including home-monitoring and strategies for discontinuing ambulatory therapy.

METHODS

A web-based three-part questionnaire was sent to 633 neonatal units in 36 European countries (July-October 2025). One response per unit was permitted. The survey collected data on policies and practises regarding discharge on caffeine, criteria for stopping therapy, and post-discharge monitoring. Responses were analysed descriptively.

RESULTS

Complete responses were obtained from 125 units in 21, revealing wide variation in practise patterns. Fifty-eight per cent of participating centres reported discharging preterm infants on continued caffeine therapy at least occasionally. Among those units, 58% reported prescribing home-monitoring routinely for infants discharged on caffeine therapy. Overall, significant differences in practise existed between geographical regions but not between high- and low-volume centres.

CONCLUSIONS

Discharging preterm infants on continued caffeine therapy is a widespread practise among neonatologists in Europe, with considerable variation among regions and differing strategies concerning home-monitoring and discontinuation of treatment.