Neonatal Morphine Exposure in Very Preterm Infants—Cerebral Development and Outcomes - 24/04/15
Abstract |
Objective |
To investigate the association of morphine exposure in very preterm infants with cerebral volumes and neurodevelopmental outcome from birth through middle childhood.
Study design |
Observational study of very preterm infants in the Victorian Infant Brain Study cohort. A total of 230 infants born <30 weeks' gestational age or <1250 g were recruited from all admissions to the neonatal intensive care unit of the Royal Women's Hospital. Fifty-seven (25%) infants received morphine analgesia during their neonatal intensive care unit stay at the attending physician's discretion. Primary outcomes were regional brain volumes at term and 7 years; neurobehavioral performance at term; and cognitive, motor, emotional, behavioral, communication, and executive function scores at age 2 and 7 years. Linear regressions were used to compare outcomes between participants who did and did not receive morphine.
Results |
At term, preterm infants who received morphine had similar rates of gray matter injury to no-morphine infants, but a trend toward smaller cortical volumes in the orbitofrontal (Pleft = .002, Pright = .01) and subgenual (Pleft = .01) regions. At 7 years, cortical volumes did not differ between groups. At 2 years, morphine-exposed children were more likely to show behavioral dysregulation (P = .007) than no-morphine children, but at 7 years no detrimental impacts of morphine on neurobehavioral outcome were observed.
Conclusions |
Low-dose morphine analgesia received during neonatal intensive care was associated with early alterations in cerebral structure and short-term neurobehavioral problems that did not persist into childhood.
Le texte complet de cet article est disponible en PDF.Keyword : CRIB, FOV, GM, IVH, MR, MRI, NICU, PMA, TE, TR, WM
Plan
Funded by the National Institute of Child Health and Development (R01 HD057098 and 1P30 HD062171), Doris Duke Charitable Foundation, and the National Health Medical Research Council (Project Grants 23117 and 491209 and Senior Research Fellowship 628371 [to P.A.]). The authors declare no conflicts of interest. |
Vol 166 - N° 5
P. 1200 - mai 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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