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Prenatal opioid use may affect child development through school age
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Prenatal opioid exposure may negatively impact neurocognitive and physical development, and those effects can last until adolescence, according to findings from a systematic review and meta-analysis published in JAMA Network Open.
“The results agree with our hypothesis that [prenatal opioid exposure (POE)] has a negative association with cognitive and motor outcomes, these issues are apparent from as early as 6 months, and they persist during school age,” study author Su Lynn Yeoh, a medical student from the University of New South Wales in Sydney, Australia, and colleagues wrote.
According to the authors, at least one in five pregnant women in high-income countries is reported to have used a form of opioid during pregnancy — a sign of a fast-growing global health problem.
In their analysis, Yeoh and colleagues included 26 cohort studies that compared the results of age-appropriate standardized cognitive and/or motor tests between children aged 0 years to 18 years who had any prenatal opioid exposure with drug-free controls. They used the standardized mean difference of cognitive and motor tests between the two groups of children as the main outcome.
The children were divided into three groups by mean age at the time of cognitive testing — 13 months for the toddler group, 4.5 years for the preschool group and 13 years for the school-aged group. According to the researchers, the standardized mean difference was lower in cognitive tests for children with prenatal opioid exposure (n = 1,455) at 0 to 2 years (d = –0.52; 95% CI, –0.74 to –0.31; P < .001) and 3 to 6 years (d = –0.38; 95% CI, –0.69 to –0.07; P < .001) compared with drug-free controls (n= 2,982). They reported no significant difference for children aged 7 to 18 years (d = –0.44; 95% CI, –1.16 to 0.28; P = .23).
At up to 6 years of age, motor scores were lower in 688 children with prenatal opioid exposure, compared with 1,500 nonexposed children (d = 0 .49; 95% CI, 0.23-0.74; P < .001), the researchers reported.
“The exact cause and association of these findings with clinical factors and environmental adversities are unclear but suggest that children with POE should be provided long-term support and intervention beyond infancy,” they wrote. – by Joe Gramigna
Disclosures: The authors report no relevant financial disclosures.
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