Neonatal morphine in extremely and very preterm neonates: its effect on the developing brain - a review

Juliette Schuurmans, Manon Benders, Petra Lemmers, Frank Van Bel*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


OBJECTIVE: Preterm infants requiring intensive care experience a large number of stressful and painful procedures. Management of stress and pain is therefore an important issue. This review provides an overview of the research on the use of morphine and its neurodevelopmental effects on this vulnerable group of neonates.

METHODS: A structural literature search of both experimental and clinical data has been done using an electronic database (PubMed), but also relevant reference lists and related articles were used.

RESULTS: A total of 39 sources were considered relevant for this review to elucidate the effects of morphine on the developing brain. The results showed that both animal experimental and clinical data displayed conflicting results on the effects of neonatal morphine on neurodevelopmental outcome. However, in contrast to specific short-term neurological outcomes long-term neurodevelopmental outcome does not seem to be adversely affected by morphine.

CONCLUSION: After a careful review of the literature, no definite conclusions concerning the effects of neonatal morphine on the long-term neurodevelopmental outcome in extremely premature neonates can be drawn. More prospectively designed trials should be conducted using reliable and validated pain assessment scores to evaluate effects of morphine on long-term neurodevelopmental outcome to demonstrate a beneficial or adverse effect of morphine in preterm infants.

Original languageEnglish
Pages (from-to)222-228
Number of pages7
JournalJournal of Maternal-fetal & Neonatal Medicine
Issue number2
Publication statusPublished - Jan 2015


  • Extremely and very preterm neonates
  • Long-term neurodevelopmental outcome
  • Morphine


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