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Efectos en el desarrollo neurológico de los opioides en niños prematuros - Una revisión sistemática y un metanálisis
Maya Rakshasbhuvankar1, Chandra Rath2, Sachin Agrawal2
1General Paediatrics, Perth Children's Hospital, Western Australia, Australia; Neonatology, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia.
Early human development
|August 20, 2025
Resumen
El uso de opiáceos en bebés prematuros no parece aumentar el riesgo de deterioro del desarrollo neurológico. Sin embargo, la evidencia es muy limitada, y algunos estudios sugieren posibles impactos negativos en las habilidades motoras.
Área de la Ciencia:
- Neonatología
- Pediatría del desarrollo
- Farmacología
Sus antecedentes:
- Los opiáceos se administran con frecuencia a los bebés prematuros para el tratamiento del dolor y la angustia en las unidades de cuidados intensivos neonatales.
- Existen preocupaciones con respecto a los posibles efectos adversos de la exposición a opiáceos en el desarrollo neurológico infantil.
Objetivo del estudio:
- Revisar sistemáticamente los ensayos controlados aleatorios (ECA) y los estudios observacionales (EOS) que investigan el impacto de los opiáceos en los resultados del desarrollo neurológico en los bebés prematuros.
Principales métodos:
- Se realizó una revisión sistemática siguiendo las directrices de la Colaboración Cochrane.
- Incluidos los ensayos controlados aleatorios (ECA) y los estudios observacionales (SO).
- Se utilizó la síntesis cuantitativa (agrupación) en la medida de lo posible; la síntesis cualitativa para otros datos.
Principales resultados:
- La revisión incluyó 16 estudios (13 OS, 3 ECA) con 3173 niños.
- No se encontró un aumento del riesgo de deterioro del desarrollo neurológico (evidencia de muy baja certeza).
- Se observaron puntuaciones motoras más bajas en lactantes expuestos a opioides a los 2 o 3 años; el análisis cualitativo mostró efectos variables de los opioides.
Conclusiones:
- La evidencia actual sobre los efectos de los opiáceos en el desarrollo neurológico del bebé prematuro no es concluyente.
- La certeza de las pruebas disponibles se califica como "muy baja".
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