Mental health and use of health care services in opioid-exposed school-aged children compared to foster children

Abstract

Given the concerns raised regarding the effects of prenatal exposure to methadone and buprenorphine on the developmental outcomes of the children, this study assessed mental health and use of services in a national sample of school-aged children (N = 78) born to women enrolled in opioid maintenance treatment during pregnancy, compared with a group of foster children (N = 140). The majority of the opioid-exposed children lived with their birth parent(s) at the time of assessment (N = 62), while 16 lived in foster homes. Caregivers completed the Strengths and Difficulties Questionnaire (SDQ) and the Reactive Attachment Disorder scale. Teachers completed the SDQ. Three kinds of services were included in measuring service use: school-based education services, child mental health services, and hospital-based habilitation services. The main finding of the study is that children prenatally exposed to methadone or buprenorphine living with their family of origin had significantly better mental health status than their foster-placed counterparts and that of the comparison group of foster children. In addition, the exposed children living at home had less child welfare involvement, and only half of them were using any of the three services measured. The odds for using services increased significantly in accordance with increasing mental health problems, independent of group affiliation, indicating a need-based access to services. In line with other studies, we found that the odds for using one or more services was 2.3 times greater for boys than for girls. Our results contribute to a more-nuanced understanding of the developmental outcomes of prenatal exposure to methadone and buprenorphine, and factors associated with increased service use in groups of at-risk children.

Prenatal exposure to opioids and neurodevelopment in infancy and childhood: A systematic review

“…Behavioral problems were assessed in 14 studies in this age group ( 30 , 37 , 38 , 40 , 47 , 57 , 71 , 72 , 76 , 78 , 85 , 87 , 96 , 98 ). The most common instrument ( n = 6) used to assess behavior was the Child Behavior Checklist (CBCL) in middle childhood.…”

Children born to women in opioid maintenance treatment: A longitudinal study of child behavioral problems and parenting stress

“…Previous publications from this study group have addressed various aspects of both parental and child functioning (17,35,(38)(39)(40) throughout the 8-year follow-up-period. Here we analyze key outcomes across the whole study period, focusing primarily on parenting stress and child behavioral problems.…”

“…As a result, studies on OMT cohorts in this country have shown very little concomitant drug use in pregnancy and birth parameters of children born to mothers in OMT are within the normal ranges (15,16). A substantial number of mothers retain custody 8 years after delivery and a recent study showed that children growing up with parents in stable OMT have significantly better mental health in early school age than other vulnerable groups such as children placed in foster care (17).…”

Prenatal opioid exposure and subsequent risk of neuropsychiatric disorders in children: nationwide birth cohort study in South Korea

“… 11 Opioid exposure during the prenatal and infancy periods might be an emerging risk factor for neuropsychiatric outcomes. While previous studies reported that exposure to opioids during the prenatal period is associated with neuropsychiatric disorders, such as attention deficit hyperactivity disorder, alcohol misuse, and depression, 12 13 others suggest that exposure to opioids during pregnancy may not be deleterious to early childhood neurobehavioural development. 14 15 Given the potential confounding factors and limited cohort size in earlier research, 16 a more precise investigation with a large scale birth cohort is warranted.…”