Reduced fetal growth in methadone-maintained pregnancies is not fully explained by smoking or socio-economic deprivation

Mactier, Helen; Shipton, Deborah; Dryden, Carol; Tappin, David

doi:10.1111/add.12400

Cited by 35 publications

(29 citation statements)

References 26 publications

(45 reference statements)

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“…Methadone in pregnancy is associated with improved antenatal care, reduced maternal morbidity and improved neonatal outcomes (Burns et al, 2007) although a recent study found low birth weight in those on treatment compared to general population (Mactier et al, 2014). There are less data regarding buprenorphine in pregnancy, though evidence is increasing Minozzi et al, 2013b;Wurst et al, 2016).…”

Section: Opioid Misuse/dependencementioning

confidence: 99%

British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

et al. 2017

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Decisions about the use of psychotropic medication in pregnancy are an ongoing challenge for clinicians and women with mental health problems, due to the uncertainties around risks of the illness itself to mother and fetus/infant, effectiveness of medications in pregnancy and risks to the fetus/infant from in utero exposure or via breast milk. These consensus guidelines aim to provide pragmatic advice regarding these issues. They are divided into sections on risks of untreated illness in pregnancy; general principles of using drugs in the perinatal period; benefits and harms associated with individual drugs; and recommendations for the management of specific disorders.

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Section: Opioid Misuse/dependencementioning

confidence: 99%

British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

et al. 2017

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“…Consequently, it is possible that prenatal opioid contact has an adverse neurological outcome on humanoid fetuses. Children born to mothers involved in opioid and poly-substance consumption during pregnancy regularly have less birth weight than control groups (43,44). Low birth weight has been proven to be a prognosticator of later cognitive capacities (45,46), socio-emotional functioning, decision-making functioning, academic success and neuroanatomical physiognomies, even for normal birth weight variants (32).…”

Section: Pathophysiology and Etiologymentioning

confidence: 99%

A Review of Neurobehavioral Challenges in Children Exposed Prenatally to Intrauterine Opioid

Alaedini¹,

Haddadi²,

Asadian³

2017

J Pediatr Rev

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Context: Substance abuse has remained a worldwide issue for many years and in recent decades there has been a major growth in the number of individuals consuming opioids. Several studies have discovered that young kids who have been exposed to opioids develop greater damages in overall intellectual capabilities and neurobehavioral functions than non-exposed children. Evidence Acquisition: The purpose of this study was to evaluate the surviving texts on the incidence of challenging behavior among kids due to prenatal medication contact. Overall, out of 84 identified manuscripts, 18 were established to consider intellectual, psychomotor, and behavior consequences in opioid-exposed infants, precollege and college children when matched with healthy no-opioid-exposed controls. Results:The results indicate that children exposed to opioid in utero may be cognitively affected over time, even once located in stable families on an actual early age. Somewhat, susceptibilities seem to rise by age for girls, and the unprotected boys persist behind non exposed boys entirely through infancy and into college age. Therefore, there looks to be a constant deleterious consequence of factors associated with prenatal medication contact over time. Conclusions:The results indicate children exposed to opioid in utero may be cognitively affected over time, even once located in stable families on an actual early age. The natural susceptibilities of prenatally drug-exposed children can affect initial intellectual skills which yet again are extremely associated with advanced mental capabilities. It is feasible that pre-and postnatal genetic susceptibilities and ecological issues cooperate in a transactional method through the child's lifespan.

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“…[43][44][45][46] Long-term effects on cognition and behavior: Heavy maternal alcohol consumption during pregnancy is associated with neuropsychological difficulties in affected children ranging from subtle learning and/or behavioral problems to severe intellectual impairment. 12,47 A variety of behavioral and cognitive difficulties, including deficits in visuospatial functioning, memory and learning, attention, selfregulation, executive functioning and motor skills are commonly seen. 47 There is convincing evidence that detrimental effects of alcohol on the developing fetal brain underlay these neurobehavioral problems, with proposed mechanisms of neurotoxicity supported by extensive animal-and cell culture research.…”

Section: -21mentioning

confidence: 99%

“…12,47 A variety of behavioral and cognitive difficulties, including deficits in visuospatial functioning, memory and learning, attention, selfregulation, executive functioning and motor skills are commonly seen. 47 There is convincing evidence that detrimental effects of alcohol on the developing fetal brain underlay these neurobehavioral problems, with proposed mechanisms of neurotoxicity supported by extensive animal-and cell culture research. [48][49][50] A wide range of neuropsychological impairments have also been associated with prenatal exposure to drugs other than alcohol, however, a far more limited number of studies exist to answer whether these impairments are caused by specific drugs.…”

Section: -21mentioning

confidence: 99%

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Cerebral Magnetic Resonance Imaging in Children With Prenatal Drug Exposure

Sirnes

Elgen

Chong

et al. 2016

Clin Pediatr (Phila)

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This study aimed to evaluate cerebral magnetic resonance imaging (MRI) scans of children with prenatal drug exposure in a clinical context. A hospital-based cohort of 10- to 14-year-old children, prenatally exposed to alcohol, opioids, and polysubstances, and a group of sex- and age-matched controls were examined with cerebral MRI. Scans obtained from 34 exposed children and 40 controls were scored based on the presence and degree of pathology by an experienced pediatric neuroradiologist blinded to the participants’ background. Overall visual detectable MRI pathology was found in 35% of the exposed children and 33% of the controls (odds ratio = 1.08; 95% confidence interval = 0.36-3.25). No specific imaging pattern following prenatal drug exposure was seen by the means of simple visual analysis of cerebral MRI scans. Although cerebral MRI is feasible, it is probably of limited value in the clinical assessment of children with prenatal drug exposure.

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Reduced fetal growth in methadone-maintained pregnancies is not fully explained by smoking or socio-economic deprivation

Abstract: Reduced fetal growth in infants of opioid-dependent mothers prescribed methadone maintenance in pregnancy is not fully explained by cigarette smoking, area deprivation, maternal age or parity.

Cited by 35 publications

References 26 publications

British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

A Review of Neurobehavioral Challenges in Children Exposed Prenatally to Intrauterine Opioid

Cerebral Magnetic Resonance Imaging in Children With Prenatal Drug Exposure

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