Morphine exposure and neurodevelopmental outcome in extremely preterm infants (2024)

Luzzati, M., Coviello, C., Swarenburg-Veye, H., Dudink, J., Dani, C., Koopmans, C., deVries, L. S., Groenendaal, F., Benders, M., & Tataranno, M. L. (2021). Morphine exposure and neurodevelopmental outcome in extremely preterm infants. Pediatric Research, 90(SUPPL 1), 8-8. Article 478. https://doi.org/10.1038/s41390-021-01757-3

Luzzati, Michele ; Coviello, Caterina ; Swarenburg-Veye, Henriette et al. / Morphine exposure and neurodevelopmental outcome in extremely preterm infants. In: Pediatric Research. 2021 ; Vol. 90, No. SUPPL 1. pp. 8-8.

@article{9fffcde5d2cb4826a7ad288c724bbedc,

title = "Morphine exposure and neurodevelopmental outcome in extremely preterm infants",

abstract = "Background: Opioids are the most common drugs used to treat pain and stress in infants receiving mechanical ventilation in the NICU. However, controversial data regarding their effects on long-term neurological outcome have been reported.Methods: We conducted a retrospective study in extremely preterm infants (gestational age (GA) <28 weeks), admitted to the Wilhelmina Children{\textquoteright}s Hospital NICU, Utrecht, between 2008 and 2011 with the aim to investigate the association between morphine exposure up to term age and neurodevelopmental outcome at 2 and 5 years. Morphine administration was expressed as cumulative dose (mg/kg) until term-equivalent age (TEA). Neurodevelopmental outcome was assessed at 2 years with the Bayley Scales of Infant and Toddler Development (BSID-III-NL) and at 5 years with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III-NL). Multivariable linear regression analysis was used to assess the association between morphine exposure and outcome. Analyses were adjusted for confounders: GA, patent ductus arteriosus, long-term mechanical ventilation (>7 days), postnatal corticosteroids, number of painful procedures, intraventricular hemorrhage (IVH), white matter injury (WMI), cerebellar hemorrhage and maternal education.Results: 106 extremely preterm infants were included in the study, 64 received morphine (60.4%) at a mean dose 2.03 ± 2.09 mg/kg during their NICU admission. Infants exposed to morphine were more frequently male, had a lower GA and birth weight, longer mechanical ventilation, a higher incidence of IVH, bronchopulmonary dysplasia and WMI at TEA compared to not-exposed infants. Moreover, exposed subjects revealed a significantly worse motor performance at 2 years (p < 0.005), whereas no differences were observed in cognitive and language of Bayley-III-NL and in WPSSI-III-NL score, respectively. At regression analysis morphine exposure did not represent a risk factor for a worse Bayley-III-NL scores at 2 years. Nevertheless, morphine-exposure resulted a risk factor for a lower Fullscale-IQ scores (p = 0.008, B = −9.3, CI −15.6 −3.1) and Performance-IQ scores (p = 0.005, B = −17.5, CI −27.9 −7) at 5 years of age.Conclusion: Morphine exposure in extremely preterm infants is not associated with neurological outcome at 2 years. However, an association is found with poorer Fullscale -IQ and Performance IQ at 5 years. Future, prospective studies with larger sample sizes are needed to confirm these findings.",

author = "Michele Luzzati and Caterina Coviello and Henriette Swarenburg-Veye and Jeroen Dudink and Carlo Dani and Corine Koopmans and deVries, {Linda S.} and Floris Groenendaal and Manon Benders and Tataranno, {Maria Luisa}",

year = "2021",

month = oct,

doi = "10.1038/s41390-021-01757-3",

language = "English",

volume = "90",

pages = "8--8",

journal = "Pediatric Research",

issn = "0031-3998",

publisher = "Lippincott Williams and Wilkins",

number = "SUPPL 1",

}

Luzzati, M, Coviello, C, Swarenburg-Veye, H, Dudink, J, Dani, C, Koopmans, C, deVries, LS, Groenendaal, F, Benders, M & Tataranno, ML 2021, 'Morphine exposure and neurodevelopmental outcome in extremely preterm infants', Pediatric Research, vol. 90, no. SUPPL 1, 478, pp. 8-8. https://doi.org/10.1038/s41390-021-01757-3

Morphine exposure and neurodevelopmental outcome in extremely preterm infants. / Luzzati, Michele; Coviello, Caterina; Swarenburg-Veye, Henriette et al.
In: Pediatric Research, Vol. 90, No. SUPPL 1, 478, 10.2021, p. 8-8.

Research output: Contribution to journal › Meeting Abstract › Academic

TY - JOUR

T1 - Morphine exposure and neurodevelopmental outcome in extremely preterm infants

AU - Luzzati, Michele

AU - Coviello, Caterina

AU - Swarenburg-Veye, Henriette

AU - Dudink, Jeroen

AU - Dani, Carlo

AU - Koopmans, Corine

AU - deVries, Linda S.

AU - Groenendaal, Floris

AU - Benders, Manon

AU - Tataranno, Maria Luisa

PY - 2021/10

Y1 - 2021/10

N2 - Background: Opioids are the most common drugs used to treat pain and stress in infants receiving mechanical ventilation in the NICU. However, controversial data regarding their effects on long-term neurological outcome have been reported.Methods: We conducted a retrospective study in extremely preterm infants (gestational age (GA) <28 weeks), admitted to the Wilhelmina Children’s Hospital NICU, Utrecht, between 2008 and 2011 with the aim to investigate the association between morphine exposure up to term age and neurodevelopmental outcome at 2 and 5 years. Morphine administration was expressed as cumulative dose (mg/kg) until term-equivalent age (TEA). Neurodevelopmental outcome was assessed at 2 years with the Bayley Scales of Infant and Toddler Development (BSID-III-NL) and at 5 years with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III-NL). Multivariable linear regression analysis was used to assess the association between morphine exposure and outcome. Analyses were adjusted for confounders: GA, patent ductus arteriosus, long-term mechanical ventilation (>7 days), postnatal corticosteroids, number of painful procedures, intraventricular hemorrhage (IVH), white matter injury (WMI), cerebellar hemorrhage and maternal education.Results: 106 extremely preterm infants were included in the study, 64 received morphine (60.4%) at a mean dose 2.03 ± 2.09 mg/kg during their NICU admission. Infants exposed to morphine were more frequently male, had a lower GA and birth weight, longer mechanical ventilation, a higher incidence of IVH, bronchopulmonary dysplasia and WMI at TEA compared to not-exposed infants. Moreover, exposed subjects revealed a significantly worse motor performance at 2 years (p < 0.005), whereas no differences were observed in cognitive and language of Bayley-III-NL and in WPSSI-III-NL score, respectively. At regression analysis morphine exposure did not represent a risk factor for a worse Bayley-III-NL scores at 2 years. Nevertheless, morphine-exposure resulted a risk factor for a lower Fullscale-IQ scores (p = 0.008, B = −9.3, CI −15.6 −3.1) and Performance-IQ scores (p = 0.005, B = −17.5, CI −27.9 −7) at 5 years of age.Conclusion: Morphine exposure in extremely preterm infants is not associated with neurological outcome at 2 years. However, an association is found with poorer Fullscale -IQ and Performance IQ at 5 years. Future, prospective studies with larger sample sizes are needed to confirm these findings.

AB - Background: Opioids are the most common drugs used to treat pain and stress in infants receiving mechanical ventilation in the NICU. However, controversial data regarding their effects on long-term neurological outcome have been reported.Methods: We conducted a retrospective study in extremely preterm infants (gestational age (GA) <28 weeks), admitted to the Wilhelmina Children’s Hospital NICU, Utrecht, between 2008 and 2011 with the aim to investigate the association between morphine exposure up to term age and neurodevelopmental outcome at 2 and 5 years. Morphine administration was expressed as cumulative dose (mg/kg) until term-equivalent age (TEA). Neurodevelopmental outcome was assessed at 2 years with the Bayley Scales of Infant and Toddler Development (BSID-III-NL) and at 5 years with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III-NL). Multivariable linear regression analysis was used to assess the association between morphine exposure and outcome. Analyses were adjusted for confounders: GA, patent ductus arteriosus, long-term mechanical ventilation (>7 days), postnatal corticosteroids, number of painful procedures, intraventricular hemorrhage (IVH), white matter injury (WMI), cerebellar hemorrhage and maternal education.Results: 106 extremely preterm infants were included in the study, 64 received morphine (60.4%) at a mean dose 2.03 ± 2.09 mg/kg during their NICU admission. Infants exposed to morphine were more frequently male, had a lower GA and birth weight, longer mechanical ventilation, a higher incidence of IVH, bronchopulmonary dysplasia and WMI at TEA compared to not-exposed infants. Moreover, exposed subjects revealed a significantly worse motor performance at 2 years (p < 0.005), whereas no differences were observed in cognitive and language of Bayley-III-NL and in WPSSI-III-NL score, respectively. At regression analysis morphine exposure did not represent a risk factor for a worse Bayley-III-NL scores at 2 years. Nevertheless, morphine-exposure resulted a risk factor for a lower Fullscale-IQ scores (p = 0.008, B = −9.3, CI −15.6 −3.1) and Performance-IQ scores (p = 0.005, B = −17.5, CI −27.9 −7) at 5 years of age.Conclusion: Morphine exposure in extremely preterm infants is not associated with neurological outcome at 2 years. However, an association is found with poorer Fullscale -IQ and Performance IQ at 5 years. Future, prospective studies with larger sample sizes are needed to confirm these findings.

U2 - 10.1038/s41390-021-01757-3

DO - 10.1038/s41390-021-01757-3

M3 - Meeting Abstract

SN - 0031-3998

VL - 90

SP - 8

EP - 8

JO - Pediatric Research

JF - Pediatric Research

IS - SUPPL 1

M1 - 478

ER -

Luzzati M, Coviello C, Swarenburg-Veye H, Dudink J, Dani C, Koopmans C et al. Morphine exposure and neurodevelopmental outcome in extremely preterm infants. Pediatric Research. 2021 Oct;90(SUPPL 1):8-8. 478. doi: 10.1038/s41390-021-01757-3