ArticlePediatric research2023
Early-life exposure to analgesia and 18-month neurodevelopmental outcomes in very preterm infants.
Article in Pediatric research, 2023. 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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Who cites it
13 citing papers in PubMed, 23 citations in OpenAlex.
- Effects of a less invasive suction protocol on pain and physiological stability in preterm infants receiving non-ınvasive ventilation: a randomized controlled trial.BMC pediatrics · 2026Trial
- Cumulative exposure to opioids and benzodiazepines in extremely preterm neonates.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Opioid exposure on the preterm brain: qualitative and quantitative MRI analysis.Intensive care medicine. Paediatric and neonatal · 2026Article
- Sweet relief or lasting impacts? Review of neonatal pain and sucrose in developing rodents.Pain reports · 2025Article
- Continuous wireless sensor monitoring with applied diagnostics: Clinical Sensor Pain Scale and Automated Sensor Pain Scale in the NICU.BMJ health & care informatics · 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
- Neonatal Sucrose and Internalizing Behaviors at 18 Months in Children Born Very Preterm.JAMA network open · 2025Article
- Attitudes of nursing professionals in adverse events in neonatal and pediatric intensive care.Revista da Escola de Enfermagem da U S P · 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
- Socioeconomic status moderates associations between hippocampal development and cognition in preterms.Annals of clinical and translational neurology · 2024Article
- Pain Exposure and Brain Connectivity in Preterm Infants.JAMA network open · 2024Article
- Association between opioid use during mechanical ventilation in preterm infants and evidence of brain injury: a propensity score-matched cohort study.EClinicalMedicine · 2023Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundWe assessed variability of analgesic use across three tertiary neonatal intensive care units (NICUs) accounting for early-life pain, quantified as number of invasive procedures. We also determined whether analgesia exposure modifies associations between early-life pain and neurodevelopment.
methodsMulticenter prospective study of 276 very preterm infants (born <24-32 weeks' gestational age [GA]). Detailed data of number of invasive procedures and duration of analgesia exposure were collected in initial weeks after birth. Eighteen-month neurodevelopmental assessments were completed in 215 children with Bayley Scales for Infant Development-Third edition.
resultsMultivariable linear regressions revealed significant differences in morphine use across sites, for a given exposure to early-life pain (interaction p < 0.001). Associations between early-life pain and motor scores differed by duration of morphine exposure (interaction p = 0.01); greater early-life pain was associated with poorer motor scores in infants with no or long (>7 days) exposure, but not short exposure (≤7 days).
conclusionsStriking cross-site differences in morphine exposure in very preterm infants are observed even when accounting for early-life pain. Negative associations between greater early-life pain and adverse motor outcomes were attenuated in infants with short morphine exposure. These findings emphasize the need for further studies of optimal analgesic approaches in preterm infants. IMPACT: In very preterm neonates, both early-life exposure to pain and analgesia are associated with adverse neurodevelopment and altered brain maturation, with no clear guidelines for neonatal pain management in this population. We found significant cross-site variability in morphine use across three tertiary neonatal intensive care units in Canada. Morphine use modified associations between early-life pain and motor outcomes. In infants with no or long durations of morphine exposure, greater early-life pain was associated with lower motor scores, this relationship was attenuated in those with short morphine exposure. Further trials of optimal treatment approaches with morphine in preterm infants are warranted.
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