The aim of this study was to evaluate the effect of early prophylactic caffeine treatment on white matter development in very preterm infants using cerebral magnetic resonance imaging. A total of 194 preterm infants (≤32 weeks gestational age) were randomly assigned to the caffeine (n = 96) or placebo (n = 93) treatment group and administered with either caffeine or placebo within 72 h after birth. Cerebral magnetic resonance imaging, including diffuse tensor imaging examination, was performed at 34–36 weeks of corrected gestational age, and the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were measured. In total, 160 infants were included in the final analysis, including 80 cases in the placebo group and 80 cases in the caffeine group. There were fewer instances of apnea of prematurity and shorter assisted ventilation times for infants in the caffeine group compared to the placebo group (p < 0.05). Infants in the caffeine group had significantly higher FA values in white matter, including the posterior limb of the internal capsule, the corpus callosum, the frontal, occipital, and parietal white matter, the cerebellum, and the cerebral peduncle, compared to infants in the placebo group. ADC values in the above white matter areas were significantly reduced in the caffeine group. However, there were no significant differences regarding the FA and ADC in the gray matter between the two groups. These results demonstrate that early administration of caffeine improves white matter micro-structural development in preterm infants, but with no significant effect on short-term complications related to prematurity.

本研究的目的是使用脑磁共振成像评估早期预防性咖啡因治疗对极早产儿白质发育的影响。共有 194 名早产儿（≤ 32 周胎龄）被随机分配到咖啡因（n = 96）或安慰剂（n = 93）治疗组，并在出生后 72 小时内服用咖啡因或安慰剂。在校正胎龄 34-36 周进行脑磁共振成像，包括弥散张量成像检查，并测量各向异性分数 (FA) 和表观扩散系数 (ADC) 值。共有160名婴儿进入最终分析，其中安慰剂组80例，咖啡因组80例。p < 0.05)。与咖啡因组婴儿相比，咖啡因组婴儿在内囊后肢、胼胝体、额叶、枕叶和顶叶白质、小脑和脑脚等白质中的 FA 值显着更高。安慰剂组。咖啡因组上述白质区域的ADC值显着降低。然而，两组之间灰质的 FA 和 ADC 没有显着差异。这些结果表明，早期服用咖啡因可以改善早产儿的白质微结构发育，但对与早产相关的短期并发症没有显着影响。