Adult consequences of prenatal drug exposure

Oei, Ju Lee

doi:10.1111/imj.13658

Cited by 46 publications

(9 citation statements)

References 69 publications

(123 reference statements)

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“…Indeed, prenatal exposure to opioids has been associated with smaller head size, lighter birthweights, and shorter body lengths in neonates [19][20][21][22][23][24]. Moreover, not only do young adults exposed to heroin prenatally exhibit cognitive and motor function deficits [25,26], but they may also have an 8-fold increased risk of depression, a 3-fold increased risk of attention disorders, and a 16-fold increased risk of substance use disorders [27]. As substance use disorder is considered a disease, it is critical to understand how the generational effects of opioid exposure manifest in not only newborns, but adults as well.…”

Section: Generational Inheritancementioning

confidence: 99%

Generational Effects of Opioid Exposure

2021

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The inheritance of substance abuse, including opioid abuse, may be influenced by genetic and non-genetic factors related to the environment, such as stress and socioeconomic status. These non-genetic influences on the heritability of a trait can be attributed to epigenetics. Epigenetic inheritance can result from modifications passed down from the mother, father, or both, resulting in either maternal, paternal, or parental epigenetic inheritance, respectively. These epigenetic modifications can be passed to the offspring to result in multigenerational, intergenerational, or transgenerational inheritance. Human and animal models of opioid exposure have shown generational effects that result in molecular, developmental, and behavioral alterations in future generations.

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Section: Generational Inheritancementioning

confidence: 99%

Generational Effects of Opioid Exposure

2021

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“…Expectant mothers with substance misuse disorders reported increased benefit from integrating substance misuse treatment with other services [5]. Nevertheless, research, policies, and guidelines are mainly focused on small-study, single interventions, that have proven ineffective on their own [6][7][8][9][10]. The growing epidemic of substance misuse in pregnancy highlights that there are multifactorial issues that remain unaddressed.…”

Section: Introductionmentioning

confidence: 99%

Identifying Targets to Improve Antenatal Care for Substance Misuse in Pregnancy: An Observational Study

CE¹,

Allman²,

Mann³

et al. 2021

austiniobstetgynecol

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Background: Substance misuse in pregnancy contributes to increased maternal and fetal morbidity and mortality. Women who misuse drugs are, however, less likely to attend antenatal care. An observational study of the women who attended our substance misuse antenatal clinic was undertaken to identify targets for improving antenatal care for substance misuse in pregnancy derived from trends in maternal profiles, pregnancy outcomes and childhood consequences. Methods: Data were retrospectively analysed from computer records and patient notes of the women who attended substance misuse antenatal clinic (n=100) and children born from these pregnancies (n=99). Results: The women presented with complex heterogeneous substance misuse patterns. Attendance to the clinic was “good” in 73% with poor attendance in a sub-population with high alcohol use. Special care baby unit admissions (14% vs 6%, p=0.14) and length of hospital stay were greater than the non-substance misusing group (5.3 ± 7.4 vs 1.2 ± 1.3 days, p<005). More premature infants in the substance-misuse group had birth-weights less than the tenth centile (86% vs 0%, p<0.05). At five years, a higher percentage of children in substance-misuse group had an ocular diagnosis compared with the control (22% vs 4%, p=0.0029), and increased social service involvement and out-of-home care. Conclusions: We suggest better sexual health education for women in high-risk groups. This could be achieved by better integration between services. Antenatal care should target high-risk groups with earlier intervention and longer-term follow-up of children born to substance-misusing mothers.

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“…Neonates with NAS who are not treated or followed through the early years are at greater risk of health and developmental issues (Nikoo et al. ; Oei ).…”

Section: Introductionmentioning

confidence: 99%

“…NAS develops in the first days after birth in neonates exposed prenatally to opioids, including heroin and prescribed medications, used legally or illegally (McQueen & Murphy-Oikonen 2016;Wachman et al 2018). Neonates with NAS who are not treated or followed through the early years are at greater risk of health and developmental issues (Nikoo et al 2015;Oei 2018).…”

Section: Introductionmentioning

confidence: 99%

Neonatal abstinence syndrome in countries with no to low medical opioid consumption: a scoping review

Marcellus

2018

International Nursing Review

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Aim To describe the current state of evidence on the care of neonates with neonatal abstinence syndrome in countries with low to virtually no medical opioid analgesic consumption. Background While access to opioids for medical use improves globally, misuse grows as a health concern. One unintended consequence has been an increase in the incidence of neonatal abstinence syndrome. Because most evidence is generated in countries with adequate opioid analgesic consumption, a picture of evidence in lower opioid‐consuming countries is not available. Design A scoping review methodology was employed and augmented with principles of international development literature review. Electronic database searches (PubMed and CINAHL) located 1106 articles. Google was employed to access an additional 17 non‐indexed articles. From the total of 1123 articles located, 27 articles from 15 countries were included. Results Minimal evidence was produced in low to virtually no medical opioid‐consuming countries. Sources were primarily review articles, descriptive, comparative or case reports. Seventy‐one per cent of the articles identified at least one specific clinical practice related to the care of infants with neonatal abstinence syndrome. Conclusions As opioid analgesic use increases globally, a subsequent increase in neonatal abstinence syndrome is likely. It will be beneficial for providers and policymakers to be proactive in considering implications for neonatal and maternal populations and collaborate with providers who have been gaining experience in this area. A number of these countries are heroin‐growing regions and already experiencing issues. Implications for nursing practice and health policy Policymakers may use these findings to support data collection and reporting, context and resource relevant guideline development, and advocacy for inclusion of the maternal‐infant population in global opioid research priority setting. International collaboration for establishing gender and culturally appropriate practices globally is critical.

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Adult consequences of prenatal drug exposure

Cited by 46 publications

References 69 publications

Generational Effects of Opioid Exposure

Generational Effects of Opioid Exposure

Identifying Targets to Improve Antenatal Care for Substance Misuse in Pregnancy: An Observational Study

Neonatal abstinence syndrome in countries with no to low medical opioid consumption: a scoping review

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