63 Repeated Administration of Sucrose in Hospitalized Preterm Infants and Neurodevelopment at 18 Months
Bibliographic record
Abstract
Abstract Background Preterm neonates, often hospitalized in the neonatal intensive care units (NICU), undergo multiple skin-breaking procedures. To minimize procedural pain, these infants frequently receive repeated administration of sucrose of varying concentrations and doses. Repetitive procedural pain has been associated with neurodevelopmental consequences, but long-term effects of repeated sucrose administration and volume are unknown. Objectives Our goal was to examine the association of total volume of sucrose over the NICU stay and neurodevelopment of preterm neonates at 18 months corrected gestational age (CGA). Design/Methods A prospective longitudinal observational study was conducted in four level-III Canadian NICUs. Infants <32 weeks of gestational age (GA) at birth and <10 days of life at enrollment were included. The minimally effective dose of 24% sucrose (0.1 ml) was administered prior to all skin-breaking procedures during the NICU stay. Total volume of sucrose administered for painful procedures was calculated for the full hospitalization. Infants were assessed at 18 months CGA by a trained observer using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). The standardized mean score for each Bayley-III component was reported out of 100 (±15). Scores ≥85 are considered within normal limits. The association between sucrose and 18-month composite development scores, adjusting for birthweight and maternal use of medication for depression, were conducted using GEE models accounting for NICU site. Results Of the 168 infants enrolled in the study, 118 completed the Bayley-III assessment at 18 months (60% male, mean GA at birth 28.3 [±2.2] weeks, mean birth weight [1092 (±354) grams]). Infants received an average of 5.92 (±5.59) ml of sucrose during the hospitalization for an average of 58 (±70) skin-breaking painful procedures. The mean Bayley-III scores were within normal limits; cognitive 91 (±17), language 86 (±18), motor 88 (±17). There was no statistically significant association between total sucrose volume administered and cognitive (p=0.98), language (p=0.68), and motor (p=0.29) Bayley-III scores in the adjusted analyses. Conclusion Results do not generally indicate neurodevelopmental delay in preterm infants assessed at 18 months of CGA. The association between total sucrose volume administered for painful procedures and neurodevelopment requires more research as the infant matures, to better understand the impact of sucrose on long-term neurodevelopmental outcomes and with attention to potential confounders. The relationship between the combination of sucrose and other evidence-supported interventions (e.g., skin-to-skin care, breastfeeding) for all painful procedures during the NICU and neurodevelopment also requires further investigation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".