In a groundbreaking study published in The Journal of Pediatrics, researchers have identified significant adverse effects on the brain and motor development of infants born prematurely after prenatal opioid exposure (POE). The study, conducted at the Cincinnati Children’s Hospital Medical Center and the University of Cincinnati College of Medicine, reveals higher rates of severe punctate white matter lesions (PWMLs) and lower scores on the Bayley Scales of Infant and Toddler Development-III (BSID-III) Motor subscale among these infants.
Increased Risk of Severe Punctate White Matter Lesions
The study, titled “Prenatal Opioid Exposure and Risk for Adverse Brain and Motor Outcomes in Infants Born Premature,” analyzed term-equivalent brain MRIs of 395 preterm infants (≤ 32 weeks gestational age[GA]), incorporating data on POE. The research indicates that compared with unexposed infants, the POE group exhibited an alarming increase in severe PWMLs, with 17.1% of exposed infants affected versus 3.9% of unexposed infants. These findings were significant even after adjusting for confounders, boasting an odds ratio (OR) of 4.16 (95% CI: 1.26, 13.68).
“This suggests that the association is primarily a direct adverse effect of POE on white matter, rather than being mediated through the aspects of premature birth or gestational age,” says Melinda E. Mahabee-Gittens, one of the lead authors involved in the study.
Motor Development Compromise
The research also highlights the worrying association between POE and motor development impairment. After statistical adjustments, the study found that POE was linked with a significantly lower score on the BSID-III Motor subscale by -6.2 points (95%CI: -11.8, -0.6) when compared to infants without exposure.
“Motor development is a critical aspect of early childhood, and any significant deviation from the expected norm can have long-term implications,” notes Nehal A. Parikh, another author of the study, reinforcing the seriousness of these findings.
Implications and Recommendations for Long-term Follow-up
The authors suggest that the results of this study warrant ongoing follow-up to understand the long-term effects of POE on child development. Early intervention programs may play a crucial role in mitigating the associated risks.
For healthcare professionals and policymakers, this study calls for increased attention and resources toward supporting both pregnant individuals with opioid use disorders and their children, who may need additional care due to the ramifications of prenatal opioid exposure.
Copyright and Citation Information
The remarkable findings of this study are available in more detail in the January 2024 issue of The Journal of Pediatrics. The article, available online since January 14, 2024, is copyrighted by Elsevier Inc. and can be accessed through DOI: 10.1016/j.jpeds.2024.113908.
Additional Research Context
The prevalence of opioid use during pregnancy has been a concern for several years, correlating with the increased incidence of neonatal abstinence syndrome and other developmental issues in newborns. As such, this study contributes significantly to the understanding of the long-term impact of opioids on prenatal development.
Keywords
1. Prenatal Opioid Exposure
2. Premature Infants Development
3. Brain MRI Biomarkers
4. Motor Outcome Studies
5. White Matter Lesions Children
References
1. Mahabee-Gittens, E. M., Illapani, V. S. P., Merhar, S. S., Kline-Fath, B. B., Harun, N., He, L., & Parikh, N. A. (2024). Prenatal Opioid Exposure and Risk for Adverse Brain and Motor Outcomes in Infants Born Premature. The Journal of Pediatrics. [DOI:10.1016/j.jpeds.2024.113908]
2. The National Institute on Drug Abuse. (2020). Opioid Use Disorder: Adverse Effects on Pregnancy and Neonates.
3. Committee on Obstetric Practice. (2017). Opioid Use and Opioid Use Disorder in Pregnancy.
4. Hudak, M. L., & Tan, R. C. (2012). Neonatal Drug Withdrawal. Pediatrics.
5. Patrick, S. W., Schumacher, R. E., Benneyworth, B. D., Krans, E. E., McAllister, J. M., & Davis, M. M. (2012). Neonatal Abstinence Syndrome and Associated Health Care Expenditures: United States, 2000-2009. JAMA.
