Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome

Fill, Mary-Margaret A.; Miller, Angela M.; Wilkinson, Rachel H.; Warren, Michael D.; Dunn, John R.; Schaffner, William; Jones, Timothy F.

doi:10.1542/peds.2018-0562

Cited by 93 publications

(76 citation statements)

References 31 publications

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“…The available reports on neurodevelopmental outcomes after antenatal opioid exposure and NOWS are also confounded by a variety of complex maternal and neonatal factors (11). However, consistent with our findings, published studies, including several recent meta-analyses report some degree of neurodevelopmental impairment, especially in preschool or school-age children, with impaired cognition, behavioral problems, impaired executive function, and academic challenges being most common (10)(11)(12)(13)(14)(15)(16)(31)(32)(33).…”

Section: Discussionsupporting

confidence: 87%

Prenatal Exposures Are Associated With Worse Neurodevelopmental Outcomes in Infants With Neonatal Opioid Withdrawal Syndrome

et al. 2020

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Aim: To define a developmental trajectory in infants with neonatal opioid withdrawal syndrome (NOWS) and determine whether the impacted developmental domain varies with the type of antenatal exposure. Methods: We performed a retrospective cohort study of infants treated pharmacologically for NOWS and assessed using a standardized schedule for follow-up visits. We compared outcomes of the study population to published norms using one-sample t-tests. Multivariable models examined associations with exposures in addition to opioids. Results: In our cohort of 285 infants with 9-12-months testing, 164 (55.7%) were seen at 3-4 months, and 125 (44%), at 15-18 months. The majority (58%) had intrauterine drug exposures in addition to opioids. Neurodevelopmental scores of infants with NOWS at 3-4 and 9-12 months were not different from published norms. Cognitive and language scores at 15-18 months were worse than published norms. Male sex, older maternal age, and additional barbiturate or alcohol exposure were associated with worse outcomes. Conclusion: Infants with pharmacologically treated NOWS had development similar to unexposed infants during the 1st year but worse cognitive and language scores during the 2nd year. These data support the need for a prospective follow-up of large cohorts of infants with NOWS, with systematic assessments and an evaluation of contributing factors.

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Section: Discussionsupporting

confidence: 87%

Prenatal Exposures Are Associated With Worse Neurodevelopmental Outcomes in Infants With Neonatal Opioid Withdrawal Syndrome

et al. 2020

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“…These findings remained significant after controlling for maternal tobacco use, maternal education status, birth weight, gestational age, and/or NICU admission. 57 In addition, as noted in a cohort study comparing 72 participants with opioid and polysubstance exposure with 58 participants without any established prenatal risk at 1, 2, 3, 4.5, and 8.5 years, IQ differences between groups were noted to widen with age. 58 When cognitive performance was measured over time after exposure, boys had consistently lower scores than girls.…”

Section: Educational Performance and Behaviormentioning

confidence: 87%

Cognitive and Behavioral Impact on Children Exposed to Opioids During Pregnancy

et al. 2019

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The developmental impact of opioid use during pregnancy is a subject of ongoing debate. Short-term neonatal outcomes, such as lower birth weight and neonatal abstinence syndrome, are the most well-recognized outcomes. However, knowledge gaps exist regarding longer-term neurocognitive and mental health outcomes. In this article, we summarize an expert panel discussion that was held in April 2018 by the Substance Abuse and Mental Health Services Administration and attended by national experts in the field of perinatal opioid exposure and its impact on child development. Despite the challenges with research in this area, there is emerging literature revealing an association between neonates exposed to opioids in utero and longer-term adverse neurocognitive, behavioral, and developmental outcomes. Although adverse sequalae may not be apparent in the neonatal period, they may become more salient as children develop and reach preschool and school age. Multiple variables (genetic, environmental, and biological) result in a highly complex picture. The next steps and strategies to support families impacted by opioid use disorder are explored. Model programs are also considered, including integrated care for the child and mother, parenting supports, and augmentations to home visiting.

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“…Furthermore, there is evidence suggesting that different opioids may have heterogeneous effects on weight gain (Kandall et al, 1976;Hulse et al, 1997), and recent evidence finds no evidence of significant differences in the weight trends of NAS children compared to appropriately matched counterparts (Corr et al, 2018). At the same time, there is increasing evidence regarding the long-run effects of NAS on child development (Reddy et al, 2017;Fill et al, 2018). Thus, even if NAS may have little effects on birth weight and other coarse measures of infant health, it may still have a substantial impact on human capital.…”

Section: Effects On Birth Outcomesmentioning

confidence: 99%

Prescription drug monitoring programs and neonatal outcomes

Gihleb

Giuntella

Zhang

2020

Regional Science and Urban Economics

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Any opinions expressed in this paper are those of the author(s) and not those of IZA. Research published in this series may include views on policy, but IZA takes no institutional policy positions. The IZA research network is committed to the IZA Guiding Principles of Research Integrity. The IZA Institute of Labor Economics is an independent economic research institute that conducts research in labor economics and offers evidence-based policy advice on labor market issues. Supported by the Deutsche Post Foundation, IZA runs the world's largest network of economists, whose research aims to provide answers to the global labor market challenges of our time. Our key objective is to build bridges between academic research, policymakers and society. IZA Discussion Papers often represent preliminary work and are circulated to encourage discussion. Citation of such a paper should account for its provisional character. A revised version may be available directly from the author.

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Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome

Abstract: Results of this novel analysis linking health and education data revealed that children with a history of NAS were significantly more likely to have a subsequent educational disability.

Cited by 93 publications

References 31 publications

Prenatal Exposures Are Associated With Worse Neurodevelopmental Outcomes in Infants With Neonatal Opioid Withdrawal Syndrome

Prenatal Exposures Are Associated With Worse Neurodevelopmental Outcomes in Infants With Neonatal Opioid Withdrawal Syndrome

Cognitive and Behavioral Impact on Children Exposed to Opioids During Pregnancy

Prescription drug monitoring programs and neonatal outcomes

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