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Early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol: a retrospective cohort study
BACKGROUND: Paracetamol is commonly used for analgesia and patent ductus arteriosus (PDA) treatment in preterm infants. We aimed to evaluate early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol during their neonatal admission. METHODS: This retrospective cohort study i...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group US
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10189702/ https://www.ncbi.nlm.nih.gov/pubmed/37198403 http://dx.doi.org/10.1038/s41390-023-02649-4 |
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author | Zhong, Bella Tan, Kenneth Razak, Abdul Sackett, Vathana Machipisa, Catherine Zhou, Lindsay Samiee-Zafarghandy, Samira Sehgal, Arvind Hunt, Rod W. Pharande, Pramod Malhotra, Atul |
author_facet | Zhong, Bella Tan, Kenneth Razak, Abdul Sackett, Vathana Machipisa, Catherine Zhou, Lindsay Samiee-Zafarghandy, Samira Sehgal, Arvind Hunt, Rod W. Pharande, Pramod Malhotra, Atul |
author_sort | Zhong, Bella |
collection | PubMed |
description | BACKGROUND: Paracetamol is commonly used for analgesia and patent ductus arteriosus (PDA) treatment in preterm infants. We aimed to evaluate early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol during their neonatal admission. METHODS: This retrospective cohort study included surviving infants born at <29 weeks gestation, or with a birth weight of <1000 grams. Neurodevelopmental outcomes studied were early cerebral palsy (CP) or high risk of CP diagnosis, Hammersmith Infant Neurological Examination (HINE) score and Prechtl General Movement Assessment (GMA) at 3–4 months corrected age. RESULTS: Two hundred and forty-two infants were included, of which 123 were exposed to paracetamol. After adjusting for birth weight, sex and chronic lung disease, there were no significant associations between paracetamol exposure and early CP or high risk of CP diagnosis (aOR 1.46, 95% CI 0.61, 3.5), abnormal or absent GMA (aOR 0.82, 95% CI 0.37, 1.79) or HINE score (adjusted β −0.19, 95% CI −2.39, 2.01). Subgroup analysis stratifying paracetamol exposure into <180 mg/kg or ≥180 mg/kg cumulative dose found that neither had significant effects on outcomes. CONCLUSIONS: In this cohort of extreme preterm infants, no significant association was found between exposure to paracetamol during the neonatal admission and adverse early neurodevelopment. IMPACT: Paracetamol is commonly used in the neonatal period for analgesia and patent ductus arteriosus treatment in preterm infants, although prenatal paracetamol use has been associated with adverse neurodevelopmental outcomes. Exposure to paracetamol during the neonatal admission was not associated with adverse early neurodevelopment at 3–4 months corrected age in this cohort of extreme preterm infants. The findings from this observational study is consistent with the small body of literature supporting the lack of association between neonatal paracetamol exposure and adverse neurodevelopmental outcomes in preterm infants. |
format | Online Article Text |
id | pubmed-10189702 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group US |
record_format | MEDLINE/PubMed |
spelling | pubmed-101897022023-05-19 Early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol: a retrospective cohort study Zhong, Bella Tan, Kenneth Razak, Abdul Sackett, Vathana Machipisa, Catherine Zhou, Lindsay Samiee-Zafarghandy, Samira Sehgal, Arvind Hunt, Rod W. Pharande, Pramod Malhotra, Atul Pediatr Res Clinical Research Article BACKGROUND: Paracetamol is commonly used for analgesia and patent ductus arteriosus (PDA) treatment in preterm infants. We aimed to evaluate early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol during their neonatal admission. METHODS: This retrospective cohort study included surviving infants born at <29 weeks gestation, or with a birth weight of <1000 grams. Neurodevelopmental outcomes studied were early cerebral palsy (CP) or high risk of CP diagnosis, Hammersmith Infant Neurological Examination (HINE) score and Prechtl General Movement Assessment (GMA) at 3–4 months corrected age. RESULTS: Two hundred and forty-two infants were included, of which 123 were exposed to paracetamol. After adjusting for birth weight, sex and chronic lung disease, there were no significant associations between paracetamol exposure and early CP or high risk of CP diagnosis (aOR 1.46, 95% CI 0.61, 3.5), abnormal or absent GMA (aOR 0.82, 95% CI 0.37, 1.79) or HINE score (adjusted β −0.19, 95% CI −2.39, 2.01). Subgroup analysis stratifying paracetamol exposure into <180 mg/kg or ≥180 mg/kg cumulative dose found that neither had significant effects on outcomes. CONCLUSIONS: In this cohort of extreme preterm infants, no significant association was found between exposure to paracetamol during the neonatal admission and adverse early neurodevelopment. IMPACT: Paracetamol is commonly used in the neonatal period for analgesia and patent ductus arteriosus treatment in preterm infants, although prenatal paracetamol use has been associated with adverse neurodevelopmental outcomes. Exposure to paracetamol during the neonatal admission was not associated with adverse early neurodevelopment at 3–4 months corrected age in this cohort of extreme preterm infants. The findings from this observational study is consistent with the small body of literature supporting the lack of association between neonatal paracetamol exposure and adverse neurodevelopmental outcomes in preterm infants. Nature Publishing Group US 2023-05-17 2023 /pmc/articles/PMC10189702/ /pubmed/37198403 http://dx.doi.org/10.1038/s41390-023-02649-4 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Clinical Research Article Zhong, Bella Tan, Kenneth Razak, Abdul Sackett, Vathana Machipisa, Catherine Zhou, Lindsay Samiee-Zafarghandy, Samira Sehgal, Arvind Hunt, Rod W. Pharande, Pramod Malhotra, Atul Early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol: a retrospective cohort study |
title | Early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol: a retrospective cohort study |
title_full | Early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol: a retrospective cohort study |
title_fullStr | Early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol: a retrospective cohort study |
title_full_unstemmed | Early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol: a retrospective cohort study |
title_short | Early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol: a retrospective cohort study |
title_sort | early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol: a retrospective cohort study |
topic | Clinical Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10189702/ https://www.ncbi.nlm.nih.gov/pubmed/37198403 http://dx.doi.org/10.1038/s41390-023-02649-4 |
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