Related Experiment Video

Updated: May 13, 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

85.7K

Cognitive, motor, and behavioral outcomes in preterm infants exposed to opioids

Philipp Steinbauer1, Julia Kühnl2, Karin Pichler2

  • 1Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics, Comprehensive Center for Pediatrics (CCP), Medical University of Vienna, Vienna, Austria. philipp.steinbauer@meduniwien.ac.at.

Pediatric Research
|April 12, 2025
PubMed

Insights

Opioid exposure in preterm infants may harm cognitive and motor development by age 3, but does not significantly impact overall behavior. Careful pain management in neonatal intensive care units (NICUs) is crucial.

Area of Science:

  • Neonatalogy
  • Neurodevelopmental Pediatrics
  • Pediatric Pain Management

Background:

  • Preterm infants experience numerous painful procedures, potentially impacting neurodevelopment.
  • Effective pain management, including opioid analgesia, is critical for this vulnerable population.
  • Long-term neurodevelopmental outcomes following neonatal opioid exposure require further investigation.

Purpose of the Study:

  • To assess the impact of neonatal opioid administration on cognitive, motor, and behavioral outcomes at 3 years corrected age.
  • To investigate the association between cumulative opioid exposure and neurodevelopmental trajectories in very and extremely preterm infants.
  • To provide insights into the nuanced effects of neonatal opioid use on long-term child development.

Main Methods:

  • Retrospective, single-center study of preterm infants (23-32 weeks gestation) born between 2011-2017.
  • Follow-up at 3 years corrected age, assessing cognitive and motor skills with Bayley Scales of Infant Development (BSID).
  • Behavioral outcomes evaluated using the Child Behavior Checklist (CBCL).

Main Results:

  • 333 preterm infants included: 214 non-opioid group, 119 opioid group.
  • Significant differences observed in cognitive (p=0.001) and motor scores (p=0.001) between groups.
  • Behavioral outcomes were generally normal, though the opioid group showed higher depressive scores.

Conclusions:

  • Cumulative neonatal opioid exposure is associated with poorer cognitive and motor development at 3 years corrected age.
  • Overall behavioral outcomes at 3 years were not significantly affected by neonatal opioid exposure.
  • Findings highlight the need for judicious opioid use in NICU, balancing pain control with potential developmental risks.
Abstract

More Related Videos

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats07:36

Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats

Published on: November 20, 2015

11.2K
A Preterm Rat Model for Pain Studies01:37

A Preterm Rat Model for Pain Studies

Published on: February 9, 2024

285

Related Concept Videos

Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
173
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
399
Factors Affecting Drug Response: Overview01:21

Factors Affecting Drug Response: Overview

When it comes to infants and young children, they are typically administered smaller doses of medication in comparison to adults. This is primarily because their organ functions still need to fully develop, meaning their bodies are not as efficient at metabolizing or eliminating drugs. Additionally, their blood-brain barrier is more permeable than in adults. As a result, high concentrations of drugs can easily penetrate the central nervous system (CNS), potentially leading to neurological...
1.7K
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
139
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
85