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Early Hum Dev. 2019 Jan;128:69-76. doi: 10.1016/j.earlhumdev.2018.10.010. Epub 2018 Dec 13.

Association between prenatal opioid exposure, neonatal opioid withdrawal syndrome, and neurodevelopmental and behavioral outcomes at 5-8 months of age.

Author information

1
Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM, United States of America; Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, United States of America; Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States of America. Electronic address: lbakhireva@salud.unm.edu.
2
Community Medical Center, Rocky Mountain Perinatal Institute, Missoula, MT, United States of America.
3
Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of New Mexico, Albuquerque, NM, United States of America.
4
Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States of America.
5
School of Medicine, University of New Mexico, Albuquerque, NM, United States of America.
6
Department of Pediatrics, University of New Mexico, Albuquerque, NM, United States of America.
7
The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, United States of America.
8
Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, United States of America.

Abstract

BACKGROUND:

While use of prescription opioids and medication assisted therapy (MAT) for opioid use disorder in pregnancy, as well as the incidence of neonatal opioid withdrawal syndrome (NOWS) continue to rise, little is known about outcomes for children with NOWS beyond the newborn period.

METHODS:

We examined 1) prenatal MAT exposure vs. unexposed healthy controls [HC]; and 2) treatment for NOWS and NOWS severity on infant neurodevelopmental and behavioral outcomes at 5-8 months of age in 78 maternal-infant pairs from the ENRICH prospective cohort study. Data were obtained from 3 study visits: prenatal, delivery, and neurodevelopmental evaluation at 5-8 months of age. Neurodevelopmental outcomes included the Bayley Scales of Infant Development [BSID-III], caregiver questionnaires (Parenting Stress Index [PSI-SF], Infant Behavior Questionnaire [IBQ-R], Sensory Profile), and the experimental Still-Face Paradigm (SFP).

RESULTS:

No differences in the BSID-III, PSI-SF, or IBQ-R scores were observed between MAT and HC groups; however, MAT-exposed and HC infants differed with respect to SFP self-regulation (β = -18.9; p = 0.01) and Sensory Profile sensation seeking (OR = 4.87; 95% CI: 1.55; 15.30) after adjusting for covariates. No significant differences between Treated-for-NOWS vs. not-Treated-for-NOWS were observed. Shorter timing to NOWS treatment initiation was associated with higher Total Stress (β = -9.08; p = 0.035), while longer hospitalization was associated with higher Parent-child dysfunctional interaction (p = 0.018) on PSI-SF.

CONCLUSIONS:

Our results provide additional evidence of little-to-no effect of MAT and pharmacological treatment of NOWS on infant neurodevelopmental and behavioral outcomes at 5-8 months of age. However, prolonged hospitalization might increase family psychosocial stress and requires further examination.

KEYWORDS:

Infant neurodevelopment; Medication-assisted treatment; Opioids; Parental stress; Pregnancy; Substance use disorder

PMID:
30554024
PMCID:
PMC6348117
[Available on 2020-01-01]
DOI:
10.1016/j.earlhumdev.2018.10.010
[Indexed for MEDLINE]

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