Background :<\/strong> data on preschool neurodevelopment of preterm infants according to the duration of their neonatal exposure to opioids with\/without midazolam is limited. We aimed to assess neurodevelopment outcome in children aged five years, born very preterm (24\u201331 weeks), according to exposure to these drugs.<\/p>\n\n\n\n Methods :<\/strong> secondary analysis from the French prospective cohort study EPIPAGE-2 (Etude Epid\u00e9miologique sur les Petits Ages Gestationnels, 2011). Exposure to opioids with\/without midazolam was classified as none, \u22647 or >7 days. Percentages were weighted to account for the study design. The primary outcome was moderate\/severe neurodevelopmental disabilities (NDD). Analyses were conducted using logistic regression and adjusted for perinatal confounders.<\/p>\n\n\n\n Findings :<\/strong> among 3117 survivors, 1165 (35.9%) were exposed (762\/1165 (68.0%) \u22647 days, 403\/1165 (32.0%) >7 days). Of these 49.5% received opioids only, 41.4% opioids and midazolam, and 9.1% midazolam only. Moderate\/severe NDD occurred in 17.8%, 18.9%, and 31.7% in the unexposed, exposed \u22647 days, and exposed >7 days groups, respectively. After adjustment for baseline confounders, only exposure >7 days was associated with increased rates of moderate\/severe NDD (adjusted odds ratio 2.07; 95% CI 1.32\u20133.26). After additional adjustment for severe neonatal morbidities no significant association was found between any duration of exposure and NDD.<\/p>\n\n\n\n Interpretation : exposure to opioids with\/without midazolam >7 days might be associated with a higher prevalence of moderate\/severe NDD at five years in very preterm born children but severe neonatal morbidities are a major modulator of this association.<\/p>\n\n\n\n <\/p>\n","protected":false},"excerpt":{"rendered":" Euro Surveill 2025 Mar 30 11 2400309<\/p>\n","protected":false},"featured_media":0,"template":"","class_list":["post-8542","publication","type-publication","status-publish","hentry"],"yoast_head":"\n