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Morphine use in the neonatal period and later neuropsychological development: a systematic review
Author(s) -
Gao Haixia,
Gao Honglian,
Li Mei,
Zhang Hua,
Wang Danwen,
Wang Bin
Publication year - 2021
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.14703
Subject(s) - neuropsychology , cohort , randomized controlled trial , cohort study , medicine , adverse effect , pediatrics , morphine , cognition , cognitive development , child development , neuropsychological assessment , psychology , psychiatry , anesthesia
Aim To identify and evaluate the evidence documenting the association between neonatal morphine and later childhood neuropsychological development. Method We conducted a systematic literature search of eight electronic databases from inception until June 2019. We included all randomized controlled trials (RCTs) and cohort studies recruiting neonates who received morphine treatment, and measuring neuropsychological development outcomes with a minimum follow‐up of 6 months. Results Twelve separate reports from three RCTs and five cohort studies met our inclusion criteria. Owing to the small number of the included trials and the variable study designs, a meta‐analysis was not performed. The findings from this review indicated that neonatal morphine use had no adverse effects on behaviour, cognition, motor, and executive function development at 8 to 9 years and earlier; except for the inconsistent conclusions on internalizing behavioural problems at 5 to 7 years and cognitive and motor developments at 18 months. Interpretation Why a child needs morphine may have a more profound impact on later neuropsychological development than morphine itself. The small number, high heterogeneity, and limitations of the included studies limit confidence in the result of this systematic review. What this paper adds Randomized controlled trials indicate that neonatal morphine had no adverse effect on later neuropsychological development. Cohort studies suggest that neonatal morphine might be associated with poorer motor and cognitive development. Cohort studies also suggest that neonatal morphine might be associated with more internalizing behavioural problems.