According to a recent analysis of national data by the Centers for Disease Control, the number of pregnant women with opioid use disorder (as documented at the time of delivery) more than quadrupled from 1999 through 2014. Studies of opioid exposure in pregnancy suggest increased risk for adverse pregnancy outcomes including stillbirth, low birth weight, preterm delivery, higher rates of maternal mortality, neonatal abstinence syndrome, and birth defects (including neural tube defects and congenital heart defects).
Less is known about the long-term effects of prenatal opioid exposure. In a large cohort study, researchers analyzed data from 8509 mother-child pairs in the Boston Birth Cohort, an urban, low-income, multiethnic cohort which enrolled mother-newborn pairs at birth at Boston Medical Center beginning in 1998. The children were followed from birth until 21 years of age.
Opioid exposure during pregnancy was associated with higher risk of fetal growth restriction, preterm birth, and lack of expected physiological development. In preschoolers, those exposed to opioids in utero were more likely to exhibit childhood conduct disorder and emotional disturbance, and in school-aged children, attention-deficit/hyperactivity disorder was more common in exposed children.
In this population of children, prenatal opioid exposure is not the only risk factor for worse emotional and neurodevelopmental outcomes. Low birth weight, preterm birth, environmental factors, and exposure to other stressors (e.g., poverty, violence, inconsistent parenting) may be contributory factors and may compound the effects of opioid exposure.
Ruta Nonacs, MD PhD
Azuine RE, Ji Y, Chang HY, Kim Y, Ji H, DiBari J, Hong X, Wang G, Singh GK, Pearson C, Zuckerman B, Surkan PJ, Wang X. JAMA Netw Open. 2019 Jun 5;2(6):e196405.
Brogly S. JAMA Netw Open. 2019 Jun 5;2(6):e196428. (Free Article)
Opioids in Pregnancy Threaten Baby (Medscape – free registration)
Prenatal opioid exposure could bring long-term harm to kids (Medical Xpress)
What We Can Do About Opioid Use Disorder in Pregnancy (Medscape – free registration)