Assessment of 2-Year Neurodevelopmental Outcomes in Extremely Preterm Infants Receiving Opioids and Benzodiazepines

Related Experiment Video

Updated: Oct 29, 2025

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

86.8K

Mihai Puia-Dumitrescu1, Bryan A Comstock2, Sijia Li2

  • 1Division of Neonatology, Department of Pediatrics, University of Washington, Seattle.

JAMA Network Open
|July 7, 2021
PubMed

Insights

Prolonged exposure to opioids and benzodiazepines in extremely preterm infants was linked to poorer neurodevelopmental outcomes at two years corrected age, as measured by the Bayley Scales of Infant Development-Third Edition (BSID-III). Short-term use showed no significant impact.

Area of Science:

  • Neonatal Intensive Care Unit (NICU) Medicine
  • Neurodevelopmental Pediatrics
  • Pharmacology

Background:

  • Extremely preterm (EP) infants often receive opioids and benzodiazepines during NICU hospitalization.
  • The association between these medications and long-term neurodevelopmental outcomes in EP infants is not well understood.

Purpose of the Study:

  • To examine the utilization of opioids and benzodiazepines in EP infants during their NICU stay.
  • To investigate the relationship between exposure to these drugs and neurodevelopmental outcomes at 2 years corrected age.

Main Methods:

  • Secondary analysis of the Preterm Erythropoietin Neuroprotection (PENUT) Trial cohort.
  • Included infants born between 24 and 27 weeks, 6 days gestational age.
  • Assessed neurodevelopmental outcomes using the Bayley Scales of Infant Development-Third Edition (BSID-III) at 2 years corrected age.

Main Results:

  • Of 936 EP infants, 51% received both opioids and benzodiazepines.
  • Prolonged exposure to both drug classes was associated with significantly lower cognitive, language, and motor scores on the BSID-III.
  • Short-term exposure to opioids and benzodiazepines did not show a significant association with neurodevelopmental outcomes.

Conclusions:

  • Prolonged combined use of opioids and benzodiazepines in EP infants is associated with an increased risk of poorer neurodevelopmental outcomes.
  • Findings highlight the potential long-term impact of extended medication use in this vulnerable population.
Abstract

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