ArticleThe Annals of pharmacotherapy2015
Brain Injury and Development in Preterm Infants Exposed to Fentanyl.
Article in The Annals of pharmacotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 4 of them syntheses that pooled it.
What it found
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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.
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Who cites it
61 citing papers in PubMed, 4 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- Fetal, Preterm, and Term Neonate Exposure to Remifentanil: A Systematic Review of Efficacy and Safety.Paediatric drugs · 2023Pooled it
- Systemic opioid regimens for postoperative pain in neonates.The Cochrane database of systematic reviews · 2023Pooled it
- Systemic opioids versus other analgesics and sedatives for postoperative pain in neonates.The Cochrane database of systematic reviews · 2023Pooled it
- Systemic opioid regimens for postoperative pain in neonates.The Cochrane database of systematic reviews · 2023Pooled it
- Preterm Physiologically Based Pharmacokinetic Model. Part II: Applications of the Model to Predict Drug Pharmacokinetics in the Preterm Population.Clinical pharmacokinetics · 2020Trial
- Associations between opioid exposure and brain size among extremely preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Associations between fentanyl exposure, gut microbiome and neurodevelopmental outcomes in preterm infants.Pediatric research · 2026Article
- Cumulative exposure to opioids and benzodiazepines in extremely preterm neonates.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Pain, Opioids, and Functional Connectivity in Preterm Infants.Children (Basel, Switzerland) · 2026Article
- Opioid exposure on the preterm brain: qualitative and quantitative MRI analysis.Intensive care medicine. Paediatric and neonatal · 2026Article
- Neurodevelopmental impairment in infants with necrotizing enterocolitis: a comprehensive review of mechanisms, outcomes, and emerging strategies.World journal of pediatric surgery · 2026Review
- Gut-Brain Axis in Preterm Infants with Surgical Necrotizing Enterocolitis.American journal of perinatology · 2025Review
- Cerebellar Development and the Burden of Prematurity.Cerebellum (London, England) · 2025Review
- Dexmedetomidine for analgesia and sedation for procedural pain or discomfort in newborn infants.The Cochrane database of systematic reviews · 2025Article
- Retrospective analysis of the analgosedative efficacy and safety of midazolam combined with fentanyl in mechanically ventilated neonates.Frontiers in pediatrics · 2025Article
- Procedural success and safety of a standardized less invasive surfactant administration protocol using fentanyl premedication and video laryngoscopy in preterm infants <32 weeks' gestation.Frontiers in pediatrics · 2025Article
- Fentanyl dosage for preterm infants suggested by a pharmacokinetic, -dynamic, and -genetic model.Pediatric research · 2025Article
- Impact of Intrauterine Insults on Fetal and Postnatal Cerebellar Development in Humans and Rodents.Cells · 2024Review
- Brain health in preterm infants: importance of early-life pain and analgesia exposure.Pediatric research · 2024Review
- Association between combined use of epidural analgesia and oxytocin administration during labor and offspring outcomes: a narrative review and proposal.Nagoya journal of medical science · 2024Review
1 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundFentanyl is commonly used in preterm infants. Relatively little is known regarding the neurodevelopmental outcomes of preterm infants exposed to fentanyl.
objectiveTo investigate the association between cumulative fentanyl dose and brain injury and diameters in a cohort of preterm infants.
methodsData on demographics, perinatal course, and neonatal course, including total fentanyl exposure prior to term equivalent age, were retrospectively evaluated for 103 infants born at ≤30 weeks gestational age (mean gestational age 26.9 ± 1.8 weeks) who underwent magnetic resonance imaging at term equivalent age. Magnetic resonance images were evaluated for brain injury and regional brain diameters. Developmental testing was conducted at term equivalent and 2 years of age.
resultsSeventy-eight infants (76%) received fentanyl (median cumulative dose 3 µg/kg, interquartile range 1-441 µg/kg). Cumulative fentanyl dose in the first week of life correlated with the incidence of cerebellar hemorrhage after correction for covariates (odds ratio 2.1, 95% confidence interval 1.1-4.1). Cumulative fentanyl dose before term equivalent age correlated with reductions in transverse cerebellar diameter after correction for covariates, including the presence of cerebellar hemorrhage (r = 0.461, P = 0.002). No correlation was detected between cumulative fentanyl dose and development at 2 years of age.
conclusionsHigher cumulative fentanyl dose in preterm infants correlated with a higher incidence of cerebellar injury and lower cerebellar diameter at term equivalent age. Our findings must be taken with caution, but emphasize the need for future prospective trials examining the risks and benefits of commonly used analgesic agents in preterm infants.
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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.