Thesis defence in the University of Oulu

Doctoral Candidate

Bachelor of Medicine Sanna Juujärvi

Faculty and research unit

University of Oulu Graduate School, Faculty of Medicine, PEDEGO

Field of study

Medicine

Date and time of the thesis defence

20.3.2020 12:00

Place of the thesis defence

Remote access: https://oulu.zoom.us/my/oulu.ped.jatko

Topic of the dissertation

Paracetamol in neonatal intensive care: acute and long-term effects.

Opponent

Docent Petteri Hovi, University of Helsinki

Custos

Professor Mika Rämet, University of Oulu

Paracetamol is a safe and effective drug for neonates

According to present thesis, paracetamol was found to be a safe drug in neonates considering its early and long-term effects. Paracetamol was also found to be an effective medicine in the treatment of ductus arteriosus.

Ductus arteriosus is a normal circulatory structure in foetal life that closes soon after the birth. Preterm infants have an increased risk of failure of ductal closure. Ductus arteriosus represents a risk factor for other long-term morbidities.

Paracetamol is a non-prescription medicine. It has been used for decades and today it is one of the most widely used drugs in the treatment of pain and fever worldwide. Its use in the treatment of children and neonates has been more limited. In Oulu University Hospital, intravenous paracetamol was introduced to the intensive care of newborn infants on 2009. Currently, paracetamol is used for pain and discomfort, but new indications for paracetamol use are under investigation.

In this study, full-term newborns and premature infants receiving paracetamol during intensive care were studied. Their early and long-term morbidities during the first five years were compared with control patients who did not receive paracetamol after birth. Information about long-term diseases, reported by physicians, was obtained from the National Institute for Health and Welfare. In addition, a neurologic developmental follow-up study and a cardiac ultrasound examination at two years of age were performed for the study group of very preterm infants. In addition, in this thesis, the treatments for ductus arteriosus in extremely premature infants were investigated. Ductus arteriosus can be treated medically and by surgery. The treatments of ductus arteriosus were evaluated in extremely preterm infants who were given early intravenous paracetamol. These results were compared to control patients who had not received paracetamol after birth. Most of the neonates do not need any special hospital care after birth but nearly every sixth (15-20%) infant needs it. Even routine daily care can be stressful to a small newborn, indicating the treatment of pain and discomfort. Therefore, research of new therapies and medicines is important, now and in the future.

Dissertation

Last updated: 20.3.2020