To systematically investigate the association between prenatal opioid exposure (POE) and attention-deficit hyperactivity disorder (ADHD) symptoms in children 2–18 years old, studies were searched using PubMed, CINAHL, PsycINFO, and Web of Science from January of 1950 to October of 2019. Inclusion criteria were observational studies reporting ADHD symptoms of children with POE compared with non-exposed children or normative data. The study protocol was registered with PROSPERO: CRD42018115967. Two independent reviewers extracted data on hyperactivity/impulsivity, inattention symptoms, ADHD combined subscale symptoms, and sample characteristics. Of 223 articles screened, seven met the inclusion criteria. Data represent 319 children with POE and 1308 non-exposed children from 4.3 to 11.2 mean years from five countries. POE was positively associated with childhood hyperactivity/impulsivity (d = 1.40; 95% CI, 0.49–2.31; p = 0.003), inattention (d = 1.35; 95% CI, 0.69–2.01; p < 0.0001), and combined ADHD symptoms scores (d = 1.27; 95% CI = 0.79–1.75; p < 0.0001). POE was positively associated with ADHD combined symptom scores at preschool (d = 0.83, 95% CI, 0.57, 1.09; p < 0.0001) and school age (d = 1.45, 95% CI, 0.85 to 2.04; p < 0.0001). Results suggest increased risk of ADHD symptoms during school age. Future research is needed to clarify the relationship between biological, social, and environmental risk and ADHD symptoms for children who experienced POE.

Objective: To identify trajectories of peer relationships in very preterm and term-born individuals from 6 to 26 years of age and test early life predictors of these trajectories. Method:As part of the Bavarian Longitudinal Study, 218 very preterm/very low birthweight (VP/VLBW; <32 weeks gestation / <1,500 grams) and 220 healthy term-born (37-42 weeks gestation) individuals were followed prospectively from birth to adulthood. Parent and selfreports at 6, 8, 13, and 26 years were combined into comprehensive developmentally-appropriate scores across three domains: peer acceptance, friendships, and peer problems. Latent profile analyses were used to identify trajectories across these three domains. Binary and multinomial logistic regressions were used to test the following potential predictors of trajectories: VP/VLBW status, sex, socio-economic status, neonatal medical risk, parent-infant relationship at 5 months, child inhibitory control at 20 months, and child cognitive abilities at 20 months.Results: Three trajectories were identified for peer acceptance and friendships and two trajectories were identified for peer problems. Higher cognitive abilities predicted more optimal trajectories in peer acceptance (OR: 1.

Friendships are crucial to children's socioemotional development and quality of life. Children born preterm (<37 weeks gestation) have an increased risk for social relationship difficulties, including fewer friends, but the mechanisms underlying the link between lower gestational age and fewer friendships are not clear. The prospective Bavarian Longitudinal Study investigated potential cascading effects on N = 1,181 children's friendships at 8 years. Path modelling indicated that higher gestational age predicted good early parent–infant relationship quality, good inhibitory control, and higher friendship scores. Good parent–infant relationship quality predicted good inhibitory control, which subsequently predicted low social inhibition at 6 years and higher friendship scores at 8 years. There is evidence of cascading effects from gestational age to early parent–infant relationships, to toddlers' inhibitory control, and to social inhibition, which partially explain differences in children's friendships at 8 years of age. Highlights Preterm children are at risk for social problems and fewer friends, but the mechanisms underlying this risk are not known. Path modelling showed that gestational age predicted good early parent–infant relationship and inhibitory control, which subsequently predicted low social inhibition and higher friendship scores. Cascading effects from gestational age to parent–infant relationships, to inhibitory control, and to social inhibition partially explain differences in friendships at 8 years.

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