ABSTRACT
We sought to assess risk-adjusted neonatal outcomes of extremely preterm infants who
received opioid infusion during early postnatal period. A retrospective analysis of
preterm infants ≤28 weeks' gestational age (GA) admitted to neonatal intensive care
units in the Canadian Neonatal Network was conducted comparing infants on the basis
of receipt of opioid infusion during day 1 and day 3 after birth. Rates of mortality,
severe neurological injury, severe retinopathy of prematurity, and chronic lung disease
were compared. A total 362 infants received opioid infusion on day 1 and day 3, whereas
4419 infants did not receive opioid infusion. Baseline comparison revealed higher
number of males, infants of GA <26 weeks, low Apgar score, and higher Score for Neonatal
Acute Physiology scores among those who received opioid infusion. Neonates who received
opioid infusion had higher risk for mortality (adjusted odds ratio [AOR] 1.57, 95%
confidence interval [CI] 1.13, 2.18), severe neurological injury (AOR 1.63, 95% CI
1.30, 2.04), severe retinopathy of prematurity (AOR 1. 39, 95% CI 1.08, 1.79), and
bronchopulmonary dysplasia (AOR 1.36, 95% CI 1.03, 1.79). Early exposure to opioid
infusion in the first 3 days was associated with higher risk of adverse outcomes in
extremely preterm infants.
KEYWORDS
Chronic lung disease - infant - premature - intraventricular hemorrhage - mortality
- retinopathy of prematurity - sedation - analgesic
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Prakesh S Shah
Associate Professor, Department of Pediatrics, Mount Sinai Hospital
775A—600 University Avenue, Toronto, Canada M5G1X5
eMail: pshah@mtsinai.on.ca
