Early opioid infusion and neonatal outcomes in preterm neonates ≤28 weeks' gestation.
We sought to assess risk-adjusted neonatal outcomes of extremely preterm infants who received opioid infusion during early postnatal period. A retrospective analysis of preterm infants ≤28 weeks' gestational age (GA) admitted to neonatal intensive care units in the Canadian Neonatal Network was conducted comparing infants on the basis of receipt of opioid infusion during day 1 and day 3 after birth. Rates of mortality, severe neurological injury, severe retinopathy of prematurity, and chronic lung disease were compared. A total 362 infants received opioid infusion on day 1 and day 3, whereas 4419 infants did not receive opioid infusion. Baseline comparison revealed higher number of males, infants of GA <26 weeks, low Apgar score, and higher Score for Neonatal Acute Physiology scores among those who received opioid infusion. Neonates who received opioid infusion had higher risk for mortality (adjusted odds ratio [AOR] 1.57, 95% confidence interval [CI] 1.13, 2.18), severe neurological injury (AOR 1.63, 95% CI 1.30, 2.04), severe retinopathy of prematurity (AOR 1. 39, 95% CI 1.08, 1.79), and bronchopulmonary dysplasia (AOR 1.36, 95% CI 1.03, 1.79). Early exposure to opioid infusion in the first 3 days was associated with higher risk of adverse outcomes in extremely preterm infants.
Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada M5G1X5. pshah@mtsinai.on.ca
Prakesh S
PS
Shah
Michael
M
Dunn
Shoo K
SK
Lee
Alexander C
AC
Allen
Nalini
N
Singhal
D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects*; D001997:Bronchopulmonary Dysplasia / Q000209:etiology; D002543:Cerebral Hemorrhage / Q000209:etiology; D004374:Ductus Arteriosus, Patent / Q000209:etiology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007969:Leukomalacia, Periventricular / Q000209:etiology; D016015:Logistic Models; D008297:Male; D047928:Premature Birth; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology; D012178:Retinopathy of Prematurity / Q000209:etiology; D012189:Retrospective Studies
D000701:Analgesics, Opioid