Citation

Lee SJ, Bora S, Austin N, Westerman A, Henderson JMT. Acad. Pediatr. 2019; ePub(ePub): ePub.

Affiliation

School of Psychology, Speech and Hearing, University of Canterbury, Private Bag 4800, Christchurch 8140, New Zealand. Electronic address: jacki.henderson@canterbury.ac.nz.

Copyright

(Copyright © 2019, Academic Pediatric Association, Publisher Elsevier Publishing)

DOI

10.1016/j.acap.2019.11.005

PMID

31734383

Abstract

BACKGROUND: Children born to opioid-dependent mothers are at risk of adverse neurodevelopment. The magnitude of this risk remains inconclusive.

OBJECTIVES: To conduct a meta-analysis of studies that assessed neurodevelopmental outcomes of children aged 0 to 12 years born to opioid-dependent mothers, compared with children born to non-opioid-dependent mothers, across general cognitive, language, motor, and social-emotional domains. DATA SOURCES: PubMed, CINAHL, PsycINFO, and Google Scholar databases. STUDY ELIGIBILITY CRITERIA: English-language publications between January 1993 and November 2018, including prenatally opioid-exposed and non-opioid-exposed comparison children, reporting outcomes data on standardized assessments. STUDY APPRAISAL AND SYNTHESIS METHODS: Two reviewers independently extracted data. Pooled standardized mean differences (SMDs) were analyzed using random effects models. Risk of bias was assessed with the Newcastle-Ottawa Quality Assessment Scale.

RESULTS: Across 16 studies, individual domain outcomes data were examined for between 93 to 430 opioid-exposed and 75 to 505 non-exposed infants/children. Opioid-exposed infants and children performed more poorly than non-exposed infants and children across all outcomes examined, demonstrated by lower infant cognitive (SMD=0.77) and psychomotor scores (SMD=0.52), lower general cognition/IQ (SMD=0.76) and language scores (SMD=0.65-0.74), and higher parent-rated internalizing (SMD=0.42), externalizing (SMD=0.66), and attention problems (SMD=0.72). LIMITATIONS: Most studies examined early neurodevelopment; only three reported school-age outcomes thereby limiting the ability to assess longer-term impacts of prenatal opioid exposures.

CONCLUSIONS AND IMPLICATIONS OF FINDINGS: Children born to opioid-dependent mothers are at modest- to high-risk of adverse neurodevelopment at least to middle childhood. Future studies should identify specific clinical and social factors underlying these challenges to improve outcomes.

Copyright © 2019. Published by Elsevier Inc.

Language: en

Keywords

Analgesics; Buprenorphine; Child; Child Behavior; Child Development; Cognition; Heroin; Infant; Intelligence; Language Development; Meta-Analysis; Meta-analysis; Methadone; Narcotics; Neurodevelopmental Disorders; Opiate Substitution Treatment; Opioid; Opioid-Related Disorders; Prenatal Exposure Delayed Effects; Prenatal Opioid Exposure; Psychomotor Performance