Emotional and Behavioral Trajectories of 2 to 9 Years Old Children Born to Opioid-Dependent Mothers

Abstract

Maternal opioid use in pregnancy has increased dramatically. Knowledge about children’s longer-term emotional and behavioral development after prenatal opioid exposure is scarce. A regional sample of 89 opioid-exposed and 104 non-exposed comparison children were studied prospectively at ages 2, 4.5, and 9 years using the Strengths and Difficulties Questionnaire (SDQ) completed by primary caregivers. Across all childhood assessments, opioid-exposed children obtained significantly higher total difficulties scores than non-exposed comparison children. Growth curve modeling revealed that, relative to their same age peers, opioid-exposed children’s emotional and behavioral difficulties significantly worsened over time. Moreover, fixed effects estimates showed that total difficulties trajectories were poorer for children subject to higher prenatal risk (Est = 1.78, 95% CI = [0.46, 3.09]) who were born to mothers with high levels of social adversity (1.11 [0.51, 1.71]), and were then raised in families characterized by high levels of psychosocial risk (1.94 [0.90, 2.98]) and unstable caregiving (1.91 [0.33, 3.48]). A complex set of pre- and postnatal processes contribute to opioid-exposed children’s emotional and behavioral development. Efforts to mitigate the long-term consequences of opioid use in pregnancy need to consider both children’s and their caregivers’ biopsychosocial risks.

Preschool Language Development of Children Born to Women with an Opioid Use Disorder

“…The positive effect of non-intrusive and nurturant parenting and a culturally enriched environment on children's language development seen here is especially important considering the developmental trajectory of these high-risk children. A recent study using the same population of children studied here has shown persistent developmental risks across multiple domains of psychosocial development [14]. These findings combined with those from the present study highlight the need for early identification and support for these children and their families to optimize these children's developmental opportunities.…”

“…The second reference or control group of children recruited were not exposed to opioids, and were randomly selected from the hospital booking schedule during the same period. The reference or non-exposed (NE) group consisted of 110 infants (48 male) who were born into families whose socioeconomic profiles were representative of the regional population at the time of birth [11,14]. Mothers from both groups were recruited during the third trimester or at birth.…”

“…Existing evidence suggests increased risks for a range of adverse neonatal outcomes, including poorer fetal growth and Neonatal Abstinence Syndrome, as well as the possibility that child risks may extend into early and middle childhood [3,[8][9][10][11][12][13]. However, longer-term follow-up studies are limited and remain somewhat inconclusive [10,12,14].…”

Preschool Language Development of Children Born to Opioid-Dependent Mothers

“…The second reference or control group of children recruited were not exposed to opioids, and were randomly selected from the hospital booking schedule during the same period. The reference or nonexposed (NE) group consisted of 110 infants (48 male) who were born into families whose socioeconomic profiles were representative of the regional population at the time of birth [11,14]. Mothers from both groups were recruited during the third trimester or at birth.…”

“…Existing evidence suggests increased risks for a range of adverse neonatal outcomes, including poorer fetal growth and Neonatal Abstinence Syndrome, as well as the possibility that child risks may extend into early and middle childhood [3,[8][9][10][11][12][13]. However, longer term follow-up studies are limited and inconclusive [10,12,14].…”