Neonatal Intensive Care, Hospital of Paediatrics, King Saud Medical City, Al Imam Abdul Aziz Ibn Muhammad Ibn Saud, Riyadh, 12746, Saudi Arabia.
Radiology and Medical Imaging Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Sci Rep. 2022 Mar 16;12(1):4498. doi: 10.1038/s41598-022-08677-0.
To investigate the relationship between morphine exposure in the first week of life and brain injury on term-equivalent age magnetic resonance imaging (MRI) in very preterm infants. A retrospective study included 106 infants with a birth weight of < 1500 g who were born at King Saud Medical City at ≤ 32 gestational weeks, were admitted to the neonatal intensive care unit, and underwent term-equivalent age or pre-discharge brain MRI. A univariate analysis in addition to modified log-Poisson regression with a robust variance estimator was applied, and the effect of early morphine exposure and cumulative dose in the first seven days on brain morphology and growth at term-equivalent age was determined using the Kidokoro score. Sixty-eight (64.2%) infants had received morphine in the first week of life (median cumulative dose: 1.68 mg/kg, interquartile range 0.48-2.52 mg/kg). Early initiation of morphine administration was significantly associated with high total white matter (adjusted relative risk [aRR] 1.32, 95% confidence interval [CI] 1.01-1.72) and cerebellum (aRR 1.36, 95% CI 1.03-1.81) scores and a small cerebellar volume (aRR 1.28, 95% CI 1.02-1.61). Morphine exposure in the first week of life was independently associated with white matter and cerebellar injury on term-equivalent age brain MRI in very preterm infants.
研究目的在于探究生命最初一周内吗啡暴露与极早产儿胎龄相当期颅脑磁共振成像（MRI）脑损伤之间的关系。本研究为回顾性研究，共纳入 106 名出生体重<1500g、胎龄≤32 周、入住新生儿重症监护病房且接受胎龄相当期或出院前颅脑 MRI 的极低出生体重儿。研究采用单变量分析和改良对数泊松回归分析（稳健方差估计），使用 Kidokoro 评分评估生命最初 7 天内早期吗啡暴露和累积剂量对脑形态和胎龄相当期脑生长的影响。68 名（64.2%）患儿在生命最初一周内接受了吗啡治疗（累积剂量中位数：1.68mg/kg，四分位距 0.48-2.52mg/kg）。早期开始吗啡治疗与较高的总白质（校正相对风险 [aRR] 1.32，95%置信区间 [CI] 1.01-1.72）和小脑（aRR 1.36，95% CI 1.03-1.81）评分以及较小的小脑体积（aRR 1.28，95% CI 1.02-1.61）显著相关。生命最初一周内的吗啡暴露与极早产儿胎龄相当期颅脑 MRI 显示的白质和小脑损伤独立相关。
