TY - JOUR
T1 - Early neurodevelopmental outcomes of extreme preterm infants exposed to paracetamol
T2 - a retrospective cohort study
AU - Zhong, Bella
AU - Tan, Kenneth
AU - Razak, Abdul
AU - Sackett, Vathana
AU - Machipisa, Catherine
AU - Zhou, Lindsay
AU - Samiee-Zafarghandy, Samira
AU - Sehgal, Arvind
AU - Hunt, Rod W.
AU - Pharande, Pramod
AU - Malhotra, Atul
N1 - Funding Information:
No specific funding was sought for this project. A/Prof Atul Malhotra’s research is funded by the NHMRC and Cerebral Palsy Alliance, Australia. Open Access funding enabled and organized by CAUL and its Member Institutions.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/11
Y1 - 2023/11
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85159690757&partnerID=8YFLogxK
U2 - 10.1038/s41390-023-02649-4
DO - 10.1038/s41390-023-02649-4
M3 - Article
C2 - 37198403
AN - SCOPUS:85159690757
SN - 0031-3998
VL - 94
SP - 1714
EP - 1719
JO - Pediatric Research
JF - Pediatric Research
ER -