Observational studyPediatric research2021
Long-term impact of systematic pain and sedation management on cognitive, motor, and behavioral outcomes of extremely preterm infants at preschool age.
Observational study in Pediatric research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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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.
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Who cites it
13 citing papers in PubMed, 24 citations in OpenAlex.
- Associations between opioid exposure and brain size among extremely preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Analgesia and sedation in premature infants receiving invasive ventilation: a systematic scoping review.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
- Cognitive, motor, and behavioral outcomes in preterm infants exposed to opioids.Pediatric research · 2025Article
- Neurodevelopmental outcomes at five years in children born very preterm (24-31 weeks) exposed to opioids with or without midazolam: results from the French nationwide EPIPAGE-2 cohort study.The Lancet regional health. Europe · 2025Article
- Analgesia and sedation increases bronchopulmonary dysplasia risk without significant neurodevelopmental impairment in very preterm infants.Frontiers in medicine · 2025Article
- Brain health in preterm infants: importance of early-life pain and analgesia exposure.Pediatric research · 2024Review
- Association between opioid use during mechanical ventilation in preterm infants and evidence of brain injury: a propensity score-matched cohort study.EClinicalMedicine · 2023Article
- Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum.Journal of clinical medicine · 2023Article
- Early-life exposure to analgesia and 18-month neurodevelopmental outcomes in very preterm infants.Pediatric research · 2023Article
- The Neonatal Withdrawal Assessment Tool (NWAT): pilot inter-rater reliability and content validity.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- Impact of Comorbid Prematurity and Congenital Anomalies: A Review.Frontiers in physiology · 2022Review
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Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundProviding optimal pain relief is a challenging task when caring for premature infants. The aim of this study was to compare the long-term cognitive, motor, and behavioral outcomes of preterm infants before and after the implementation of a pain and sedation protocol. In addition, we investigated whether the increased opiate administration resulting after the implementation process had an impact on these outcomes.
methodsCognitive outcomes were evaluated using the Kaufman Assessment Battery for Children (KABC), neuromotor examinations were based on Amiel-Tison, and behavioral outcomes were assessed using the parent-reported Child Behavior Checklist (CBCL).
resultsOne hundred extremely preterm infants were included in the study (control group, n = 53; intervention group, n = 47). No significant differences were found in cognitive and motor outcomes at preschool age. However, every increase in the cumulative opiate exposure for each 100 mg/kg was weakly significantly associated with a higher risk for autism spectrum features (adjusted odds ratio (aOR) = 1.822, 95% confidence interval (CI) [1.231-2.697]; P = 0.03) and withdrawn behavior (aOR = 1.822, 95% CI [1.231-2.697]; P = 0.03) at preschool age.
conclusionIncreased neonatal cumulative opiate exposure did not alter cognitive and motor outcomes but may represent a risk factor for autism spectrum and withdrawn behavior at preschool age. IMPACT: The implementation of a protocol for the management of pain and sedation in preterm infants resulted in increased cumulative opiate exposure. Our study adds further evidence that increased neonatal opiate exposure did not alter cognitive and motor outcomes but may yield a potential risk factor for autism spectrum disorders and withdrawn behavior at preschool age. A vigilant use of opiates is recommended. Further studies are needed looking for novel pain management strategies and drugs providing optimal pain relief with minimal neurotoxicity.
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