Postneonatal mental and motor development of infants exposed in utero to opioid drugs

Abstract

We compared the mental and motor development of 33 infants from innercity, African American families whose mothers used opioid drugs during pregnancy with that of 45 infants from demographically comparable families where the mothers were not users of opioids. We found that during the first 2 years of life, the children exposed to opioid drugs showed poorer functioning on Bayley Scales mental and psychomotor development indices as well as on Infant Behavior Record ratings of mental and motor functioning. Although both groups of children performed in the normal range during infancy, both groups showed sharp declines in their developmental scores during the second year of life relative to norms. The poorer performance of the opioid-exposed group in mental development was related to social-environmental risk factors; in psychomotor development, to reduced birth weight.RESUMEN: En este estudio se comparó el desarrollo mental y motor de 33 infantes que provenían de familias afro-norteamericanas de barrios pobres del centro de la ciudad y cuyas madres habían usado drogas similares al opio durante el embarazo, con 45 infantes de familias demográficamente comparables donde las madres no usaron tales drogas. Encontramos que durante los dos primeros años de vida, los niños expuestos a dichas drogas mostraron un funcionamiento más débil en los índices de desarrollo mental y sicomotor de las Escalas Bailey, así como en las clasificaciones de funcionamiento mental y motor de la Trayectoria de Comportamiento Infantil (Infant Behavior Record). Aunque ambos grupos de niños actuaron dentro de lo normal durante la infancia, los dos mostraron una declinación fuerte en cuanto a los puntajes de desarrollo durante el segundo año de vida, en lo relativo a las normas. La más débil actuación del grupo de niños expuestos a estas drogas en lo que respecta al desarrollo mental fue relacionada con factores de riesgo socio-ambientales; y en cuanto el desarrollo sicomotor, al bajo peso al momento del nacimiento.

Cognitive function of youths born to mothers with opioid and poly-substance abuse problems during pregnancy

“…The significant effect sizes were in the range of approximately 0.5 to 0.9 standard deviations. The combination of cognitive functions within the normal range but significantly worse than a non-exposed group is in accordance with previous studies of young children with prenatal opioid or poly-drug exposure (Bauman & Levine, 1986;Bunikowski et al, 1998;Hans & Jeremy, 2001;Hunt et al, 2008;Johnson et al, 1984;Logan et al, 2011;van Baar & de Graaff, 1994;Wilson, 1989;Wilson et al, 1979) and youths with such prenatal exposure (Davis & Templer, 1988;Ornoy et al, 2010).…”

“…The few studies of young children indicate the likelihood of problems within fields related to executive control and attention (Hans, 1996;Hickey, Suess, Newlin, Spurgeon, & Porges, 1995;Melinder, Konijnenberg, & Sarfi, 2013;Ornoy, Segal, Bar-Hamburger, & Greenbaum, 2001;Slinning, 2004;Wahlsten & Sarman, 2013) and behavior regulation (de Cubas & Field, 1993;Hans, 1996;Sowder & Burt, 1980). Fine motor abilities, which are often related to executive control (Rigoli, Piek, Kane, & Oosterlaan, 2012), have also been found to be worse among young children born to mothers with opioid and poly-drug use during pregnancy than among other children (Bunikowski et al, 1998;Davis & Templer, 1988;Hans & Jeremy, 2001;Logan et al, 2011). Some studies find that motor abilities are the most affected functional area (Bernstein, Jeremy, Hans, & Marcus, 1984;Hans, 1989;Wahlsten & Sarman, 2013), whereas other studies have not found significant group differences in motor abilities (van Baar, 1990).…”

“…In addition, we have almost no knowledge of how these children fare as they get older. This issue is of concern because the few existing longitudinal studies indicate that drug-exposed children do not catch up with comparable children as they age (Crea, Barth, Guo, & Brooks, 2008;Hans & Jeremy, 2001;Messinger et al, 2004;Moe & Slinning, 2001;Ornoy et al, 2010;Strauss, Starr, Ostrea, Chavez, & Stryker, 1976;van Baar & de Graaff, 1994). The few studies of older children and youths indicate worse cognitive scores and more attentional problems for these youths than for comparable control groups (Davis & Templer, 1988;Ornoy et al, 2010).…”

“…Some studies have indicated that part of the differences between opioid-or polysubstance-exposed and non-exposed children may be attributed to concordant factors, such as a non-optimal caregiving environment with drug-abusing parents (Hans & Jeremy, 2001;Lifschitz et al, 1985;Messinger et al, 2004;Moe & Slinning, 2002;Ornoy et al, 2001). It has been postulated that optimization of the postnatal environment may compensate for the biological vulnerabilities these children have (Mayes, 1999;van Baar & de Graaff, 1994).…”

Volumetric cerebral characteristics of children exposed to opiates and other substances in utero

“…Suess et al, 1997;Moe and Slinning, 2002;Moe, 2002;Slinning, 2004). This relationship can partly be explained by environmental correlates of maternal substance-abuse, including higher level of social risk (Hans and Jeremy, 2001), such as effects of poverty, stress, maternal psychopathology, disruptions in maternal care, and poorer interaction with the primary caregiver. However, developmental difficulties of children born to substance-abusing mothers likely also have potent biological foundations.…”