Early morphine infusion ups adverse outcome risk in preemies
Early morphine infusion in premature infants may increase the risk of intraventricular haemorrhage (IVH) and/or death, a recent study has found.
Researchers conducted a retrospective investigation of 420 premature infants who were intubated on admission. More than half (54.7 percent) received continuous infusions of morphine in the first 72 hours. The primary study outcome was a composite between IVH and/or mortality. Secondary outcomes included IVH of any grade, necrotizing enterocolitis, and bronchopulmonary dysplasia.
Unadjusted analysis revealed that early morphine initiation increased the likelihood of infant mortality and morbidity. This was confirmed by multivariable regression analysis. Infants aged <28 gestational weeks were significantly more likely to develop the composite outcome after early morphine infusion (adjusted relative risk, 1.37, 95 percent confidence interval, 1.1–1.71).
No such effect was reported for infants born 28–32 gestational weeks.
Additional matching with premature infants who did not receive morphine in the first 72 hours of life confirmed the negative impacts of early infusion on the composite outcome (p=0.008) and on infant mortality (p=0.009).
Early infusion did not seem to have an effect on the length of hospital stay, duration of invasive ventilation, and the use of total parenteral nutrition.
Future studies that are well-designed, randomized, and controlled in nature are needed to better elucidate the effects of early morphine initiation in intubated, premature infants, the researchers said.