Observational studyThe Journal of pediatrics2015
Neonatal morphine exposure in very preterm infants-cerebral development and outcomes.
Observational study in The Journal of pediatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 38 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 106 citations in OpenAlex.
- MRI-based brain volumes of preterm infants at term: a systematic review and meta-analysis.Archives of disease in childhood. Fetal and neonatal edition · 2022Pooled it
- Pharmacokinetics of morphine in encephalopathic neonates treated with therapeutic hypothermia.PloS one · 2019Trial
- Associations between opioid exposure and brain size among extremely preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Postmenstrual age-adjusted brain volumes and their association with early neurodevelopmental outcomes in very low birth weight infants.Scientific reports · 2026Article
- Opioid exposure on the preterm brain: qualitative and quantitative MRI analysis.Intensive care medicine. Paediatric and neonatal · 2026Article
- Cognitive, motor, and behavioral outcomes in preterm infants exposed to opioids.Pediatric research · 2025Article
- Antibiotics, Analgesic Sedatives, and Antiseizure Medications Frequently Used in Critically Ill Neonates: A Narrative Review.Children (Basel, Switzerland) · 2024Review
- Morphine exposure and prematurity affect flash visual evoked potentials in preterm infants.Clinical neurophysiology practice · 2024Article
- Early surgery in very preterm infants is associated with brain abnormalities on term MRI: a propensity score analysis.Journal of perinatology : official journal of the California Perinatal Association · 2023Observational
- The Use of Dexmedetomidine in Preterm Infants: A Single Academic Center Experience.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2023Article
- Newborn Cry Acoustics in the Assessment of Neonatal Opioid Withdrawal Syndrome Using Machine Learning.JAMA network open · 2022Article
- Association between morphine exposure and impaired brain development on term-equivalent age brain magnetic resonance imaging in very preterm infants.Scientific reports · 2022Article
- Fentanyl Exposure in Preterm Infants: Five-Year Neurodevelopmental and Socioemotional Assessment.Frontiers in pain research (Lausanne, Switzerland) · 2022Article
- Frequencies, Modalities, Doses and Duration of Computerized Prescriptions for Sedative, Analgesic, Anesthetic and Paralytic Drugs in Neonates Requiring Intensive Care: A Prospective Pharmacoepidemiologic Cohort Study in 30 French NICUs From 2014 to 2020.Frontiers in pharmacology · 2022Article
- Established severe BPD: is there a way out? Change of ventilatory paradigms.Pediatric research · 2021Review
- GABA and glutamate in the preterm neonatal brain: In-vivo measurement by magnetic resonance spectroscopy.NeuroImage · 2021Review
- Chronic Exposure to Tramadol Induces Neurodegeneration in the Cerebellum of Adult Male Rats.Neurotoxicity research · 2021Article
- Assessment of 2-Year Neurodevelopmental Outcomes in Extremely Preterm Infants Receiving Opioids and Benzodiazepines.JAMA network open · 2021Article
- Practical approaches to sedation and analgesia in the newborn.Journal of perinatology : official journal of the California Perinatal Association · 2021Review
- New techniques, new challenges-The dilemma of pain management for less invasive surfactant administration?Paediatric & neonatal pain · 2021Review
Corrections and comments
- Erratum issued
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveTo investigate the association of morphine exposure in very preterm infants with cerebral volumes and neurodevelopmental outcome from birth through middle childhood. STUDY
designObservational 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.
resultsAt 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.
conclusionsLow-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.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.