TY - JOUR
PY - 2019//
TI - Neurodevelopmental outcomes of children born to opioid-dependent mothers: a systematic review and meta-analysis
JO - Academic pediatrics
A1 - Lee, Samantha J.
A1 - Bora, Samudragupta
A1 - Austin, Nicola
A1 - Westerman, Anneliese
A1 - Henderson, Jacqueline M. T.
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - BACKGROUND: Children born to opioid-dependent mothers are at risk of adverse neurodevelopment. The magnitude of this risk remains inconclusive.
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.
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.
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.
Copyright © 2019. Published by Elsevier Inc.
Language: en
LA - en SN - 1876-2859 UR - http://dx.doi.org/10.1016/j.acap.2019.11.005 ID - ref1 ER -