@article{ref1,
title="Neurodevelopmental outcomes of children born to opioid-dependent mothers: a systematic review and meta-analysis",
journal="Academic pediatrics",
year="2019",
author="Lee, Samantha J. and Bora, Samudragupta and Austin, Nicola and Westerman, Anneliese and Henderson, Jacqueline M. T.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Children born to opioid-dependent mothers are at risk of adverse neurodevelopment. The magnitude of this risk remains inconclusive. <br><br>OBJECTIVES: To conduct a meta-analysis of studies that assessed neurodevelopmental outcomes of children aged 0 to 12 years born to opioid-dependent mothers, compared with children born to non-opioid-dependent mothers, across general cognitive, language, motor, and social-emotional domains. DATA SOURCES: PubMed, CINAHL, PsycINFO, and Google Scholar databases. STUDY ELIGIBILITY CRITERIA: English-language publications between January 1993 and November 2018, including prenatally opioid-exposed and non-opioid-exposed comparison children, reporting outcomes data on standardized assessments. STUDY APPRAISAL AND SYNTHESIS METHODS: Two reviewers independently extracted data. Pooled standardized mean differences (SMDs) were analyzed using random effects models. Risk of bias was assessed with the Newcastle-Ottawa Quality Assessment Scale. <br><br>RESULTS: Across 16 studies, individual domain outcomes data were examined for between 93 to 430 opioid-exposed and 75 to 505 non-exposed infants/children. Opioid-exposed infants and children performed more poorly than non-exposed infants and children across all outcomes examined, demonstrated by lower infant cognitive (SMD=0.77) and psychomotor scores (SMD=0.52), lower general cognition/IQ (SMD=0.76) and language scores (SMD=0.65-0.74), and higher parent-rated internalizing (SMD=0.42), externalizing (SMD=0.66), and attention problems (SMD=0.72). LIMITATIONS: Most studies examined early neurodevelopment; only three reported school-age outcomes thereby limiting the ability to assess longer-term impacts of prenatal opioid exposures. <br><br>CONCLUSIONS AND IMPLICATIONS OF FINDINGS: Children born to opioid-dependent mothers are at modest- to high-risk of adverse neurodevelopment at least to middle childhood. Future studies should identify specific clinical and social factors underlying these challenges to improve outcomes.<br><br>Copyright © 2019. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="1876-2859",
doi="10.1016/j.acap.2019.11.005",
url="http://dx.doi.org/10.1016/j.acap.2019.11.005"
}