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Arch Pediatr Adolesc Med. 2008 Aug;162(8):728-33. doi: 10.1001/archpedi.162.8.728.

Prolonged sedation and/or analgesia and 5-year neurodevelopment outcome in very preterm infants: results from the EPIPAGE cohort.

Author information

1
Department of Neonatal Medicine and Centre d'Investigation Clinique INSERM CIC004, Hôpital de Mère et l'Enfant, Boulevard Jean Monet, 44000 Nantes, France. jcroze@chu-nantes.fr

Abstract

OBJECTIVE:

To describe the long-term outcome of very preterm infants receiving prolonged sedation and/or analgesia and examine the relationship between prolonged sedation and/or analgesia and this long-term outcome.

DESIGN:

A prospective population-based study (Etude EPIdémiologique sur les Petits Ages GEstationnels [EPIPAGE]). To reduce bias, the propensity score method was used.

SETTING:

Nine regions of France.

PARTICIPANTS:

The study population included very preterm infants of fewer than 33 weeks' gestational age, born in 1997, who received mechanical ventilation and/or surgery. Main Exposure Prolonged exposure to sedative and/or analgesic drugs in the neonatal period, defined as exposure of more than 7 days to sedative and/or opioid drugs.

MAIN OUTCOME MEASURE:

Presence of moderate or severe disability at 5 years of age.

RESULTS:

The analysis concerns 1572 premature infants who received mechanical ventilation for whom information about exposure to prolonged sedation and/or analgesia in the neonatal period was available. A total of 115 were exposed and 1457 were not exposed. There was no significant difference between the number of patients lost to follow-up from the group of very preterm infants who were exposed to prolonged sedation and/or analgesia and the group who were not. Exposed very preterm infants had severe or moderate disability at 5 years (41/97; 42%) more often than those who were not exposed (324/1248; 26%). After adjustment for gestational age and propensity score, this association was no longer statistically significant (adjusted relative risk, 1.0; 95% confidence interval, 0.8-1.2).

CONCLUSION:

Prolonged sedation and/or analgesia is not associated with a poor 5-year neurological outcome after adjustment for the propensity score.

Comment in

PMID:
18678804
DOI:
10.1001/archpedi.162.8.728
[Indexed for MEDLINE]

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