The Turkish Journal of Pediatrics 2019 , Vol 61 , Num 4
The contribution of morphine sulfate to the development of necrotizing enterocolitis in preterm infants: a matched casecontrol study
Zlatan Zvizdic 1 ,Emir Milisic 1 ,Asmir Jonuzi 1 ,Sabina Terzic 2 ,Denisa Zvizdic 3
1 Department of Clinic of Pediatric Surgery, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
2 Department of Pediatric Clinic, Neonatal Intensive Care Unit, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
3 Eye Clinic, Department of Pediatric, Ophtalmology, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
DOI : 10.24953/turkjped.2019.04.007 Zvizdic Z, Milisic E, Jonuzi A, Terzic S, Zvizdic D. The contribution of morphine sulfate to the development of necrotizing enterocolitis in preterm infants: a matched case-control study. Turk J Pediatr 2019; 61: 513-519.

The aim of the study was to determine whether morphine sulfate administration is associated with an increased risk of necrotizing enterocolitis (NEC) in preterm infants supported by mechanical ventilation due to respiratory failure. The matched case-control retrospective study was carried out at the Neonatal Intensive Care Unit (NICU) of the University Clinical Center Sarajevo, on 122 preterm infants classified into total NEC group and control group. The total NEC group was further divided into medical NEC and surgical NEC subgroups. The association between the use and duration of morphine sulfate infusion and the development of NEC was evaluated in both unadjusted and adjusted analysis. Preterm infants who developed NEC were on mechanical ventilation more frequently compared to premature infants without signs of NEC (Mann- Whitney U test; p=0.0031). A positive correlation between the frequency of receiving morphine sulfate and the development of NEC was observed (Chi square test of independence; p=0.0001). The risk of NEC in preterm infants was increased by the use of morphine sulfate. Validation of this observation in other populations is warranted. Keywords : morphine sulfate, opioids, mechanical ventilation, necrotizing enterocolitis, preterm infants

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