Neonatal Abstinence Syndrome and High School Performance

Oei, Ju Lee; Melhuish, Edward; Uebel, Hannah; Azzam, Nadin; Breen, Courtney; Burns, Lucy; Hilder, Lisa; Bajuk, Barbara; Abdel-Latif, Mohamed E; Ward, Meredith C.; Feller, John M; Falconer, Janet; Clews, Sarah; Eastwood, John; Li, Annie; Wright, Ian

doi:10.1542/peds.2016-2651

Cited by 151 publications

(123 citation statements)

References 30 publications

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“…Clinical studies have shown lower numeracy, literacy, IQ, and cognitive functions in school-aged children with POE or diagnosis of NOWS [12–15]. Additionally, a few studies demonstrated motor delays in children with POE [14].…”

Section: Introductionmentioning

confidence: 99%

Association between prenatal opioid exposure, neonatal opioid withdrawal syndrome, and neurodevelopmental and behavioral outcomes at 5–8 months of age

Bakhireva

Holbrook

Shrestha

et al. 2019

Early Human Development

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Background: While use of prescription opioids and medication assisted therapy (MAT) for opioid use disorder in pregnancy, as well as the prevalence of neonatal opioid withdrawal syndrome (NOWS) continue to rise, little is known about outcomes for children with NOWS beyond the newborn period. Methods: We examined 1) prenatal MAT exposure vs. unexposed healthy controls [HC]; and 2) treatment for NOWS and NOWS severity on infant neurodevelopmental and behavioral outcomes at 5–8 months of age in 78 maternal-infant pairs from the ENRICH prospective cohort study. Data were obtained from 3 study visits: prenatal, delivery, and neurodevelopmental evaluation at 5–8 months of age. Neurodevelopmental outcomes included the Bayley Scales of Infant Development [BSID-III], caregiver questionnaires (Parenting Stress Index [PSI-SF], Infant Behavior Questionnaire [IBQ-R], Sensory Profile), and the experimental Still-Face Paradigm (SFP). Results: No differences in the BSID-III, PSI-SF, or IBQ-R scores were observed between MAT groups and HC; however, MAT-exposed and HC infants differed with respect to SFP self-regulation (β=−18.9; p=0.01) and Sensory Profile sensation seeking (OR=4.87; 95% CI: 1.55; 15.30) after adjusting for covariates. No significant differences between Treated-for-NOWS vs. not-Treated-for-NOWS were observed. Shorter timing to NOWS treatment initiation was associated with higher Total Stress (β=−9.08; p=0.035), while longer hospitalization was associated with higher Parent-child dysfunction (p=0.018) on PSI-SF. Conclusions: Our results provide additional evidence of little-to-no effect of MAT and pharmacological treatment of NOWS on infant neurodevelopmental and behavioral outcomes at 5–8 months of age. However, prolonged hospitalization might increase family psychosocial stress and requires further examination.

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Section: Introductionmentioning

confidence: 99%

Association between prenatal opioid exposure, neonatal opioid withdrawal syndrome, and neurodevelopmental and behavioral outcomes at 5–8 months of age

Bakhireva

Holbrook

Shrestha

et al. 2019

Early Human Development

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“…[49][50][51] In animals, maternal preconceptual opioid exposure is associated with altered sex-specific behavioral outcomes in both the first and second generations. 56 Although we do not wish to over interpret our results, we will have not yet been validated in the literature also show involvement in the pathogenesis of neurodevelopmental disorders (SLC9A6, 84,85 PPP1R15B 86 are associated with intellectual disability 87 ). 56 Although we do not wish to over interpret our results, we will have not yet been validated in the literature also show involvement in the pathogenesis of neurodevelopmental disorders (SLC9A6, 84,85 PPP1R15B 86 are associated with intellectual disability 87 ).…”

Section: Moud Associated With Altered Fce Protein Cargo: Pilot Analmentioning

confidence: 86%

Novel biomarkers to assess in utero effects of maternal opioid use: First steps toward understanding short‐ and long‐term neurodevelopmental sequelae

Goetzl

Thompson-Felix

Darbinian

et al. 2019

Genes Brain and Behavior

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Maternal opioid use disorder is common, resulting in significant neonatal morbidity and cost. Currently, it is not possible to predict which opioid‐exposed newborns will require pharmacotherapy for neonatal abstinence syndrome. Further, little is known regarding the effects of maternal opioid use disorder on the developing human brain. We hypothesized that novel methodologies utilizing fetal central nervous system‐derived extracellular vesicles isolated from maternal blood can address these gaps in knowledge. Plasma from opioid users and controls between 9 and 21 weeks was precipitated and extracellular vesicles were isolated. Mu opioid and cannabinoid receptor levels were quantified. Label‐free proteomics studies and unbiased small RNA next generation sequencing was performed in paired fetal brain tissue. Maternal opioid use disorder increased mu opioid receptor protein levels in extracellular vesicles independent of opioid equivalent dose. Moreover, cannabinoid receptor levels in extracellular vesicles were upregulated with opioid exposure indicating cross talk with endocannabinoids. Maternal opioid use disorder was associated with significant changes in extracellular vesicle protein cargo and fetal brain micro RNA expression, especially in male fetuses. Many of the altered cargo molecules and micro RNAs identified are associated with adverse clinical neurodevelopmental outcomes. Our data suggest that assays relying on extracellular vesicles isolated from maternal blood extracellular vesicles may provide information regarding fetal response to opioids in the setting of maternal opioid use disorder. Prospective clinical studies are needed to evaluate the association between extracellular vesicle biomarkers, risk of neonatal abstinence syndrome and neurodevelopmental outcomes.

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“…At most, follow‐up has been truncated at adolescence or even prior. There are consistent indications that prenatal drug exposure, for example, to marijuana, cocaine and opioids compromises school performance and cognitive skills from as early as 8–9 years of age and until high school. Oei et al .…”

Section: Academic Outcomesmentioning

confidence: 89%

“…At most, follow-up has been truncated at adolescence or even prior. There are consistent indications that prenatal drug exposure, for example, to marijuana, 44 cocaine 68 and opioids 69 compromises school performance and cognitive skills from as early as 8-9 years of age and until high school. Oei et al used linkage data to examine the performance on Australian standardised curriculum based tests for 2234 children diagnosed with NAS as infants to the first year of high school.…”

Section: Academic Outcomesmentioning

confidence: 99%

Adult consequences of prenatal drug exposure

Oei

2018

Internal Medicine Journal

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Maternal drug use is not new but over the last few decades, the number of mothers using drugs of addiction has escalated to epidemic levels. These drugs are both legal (e.g. prescription medication) and illegal (e.g. heroin) and all will cross the placental barrier into the developing infant. The most immediate and obvious consequence of intra-uterine drug exposure is newborn withdrawal or the Neonatal Abstinence Syndrome (NAS) which is now, with prompt recognition and treatment, an uncommon cause of neonatal death. Thousands (if not millions) of adults most likely would have had a history of passive drug exposure during gestation and the outcomes of these people are unknown. Most are physically healthy and do not need extra medical attention but the effects of prenatal drug exposure may be subtle and extensive. Drug-use disorders are accompanied by a myriad of other adverse problems, including poverty, mental and physical health problems and inadequate parenting ability that may compound the negative effects of drugs. Emerging data suggest that vulnerability to health and neurocognitive issues are pervasive and long-lasting as are lifestyle issues. This review will address current evidence in this area and highlight the knowledge gaps that must be addressed in order to optimise the outcomes for this vulnerable and marginalised but rapidly expanding population of adults.

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Neonatal Abstinence Syndrome and High School Performance

Abstract: BACKGROUND AND OBJECTIVES:Little is known of the long-term, including school,

Cited by 151 publications

References 30 publications

Association between prenatal opioid exposure, neonatal opioid withdrawal syndrome, and neurodevelopmental and behavioral outcomes at 5–8 months of age

Association between prenatal opioid exposure, neonatal opioid withdrawal syndrome, and neurodevelopmental and behavioral outcomes at 5–8 months of age

Novel biomarkers to assess in utero effects of maternal opioid use: First steps toward understanding short‐ and long‐term neurodevelopmental sequelae

Adult consequences of prenatal drug exposure

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