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Updated: Dec 26, 2025

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Cognitive Outcomes of Young Children After Prenatal Exposure to Medications for Opioid Use Disorder: A Systematic

Leah F Nelson1, Victoria K Yocum2, Keisha D Patel2,3

  • 1Addiction Medicine Fellowship Program, Department of Family and Community Medicine, University of New Mexico, Albuquerque.

JAMA Network Open
|March 19, 2020
PubMed

Insights

Prenatal exposure to medication for addiction treatment (MAT) may be linked to lower cognitive scores in children. However, this association disappears when accounting for maternal tobacco use, highlighting the need for smoking cessation support.

Area of Science:

  • Perinatal mental health
  • Child development
  • Pharmacology

Background:

  • Prenatal exposure to medication for addiction treatment (MAT) for maternal opioid use disorder is increasing.
  • The impact of MAT exposure on early childhood cognitive development requires further understanding.

Purpose of the Study:

  • To systematically review and synthesize evidence on the association between prenatal MAT exposure and cognitive development in early childhood.
  • To investigate the influence of confounding variables, such as maternal tobacco use, on this association.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases (PubMed, CINAHL, PsycINFO, Web of Science, Embase) from 1972 to 2019.
  • Inclusion criteria focused on cohort studies of children aged 1-60 months with prenatal MAT exposure, utilizing standardized cognitive assessments.
  • Meta-analysis using random-effects models was performed on data from 16 unique cohorts (1086 children).

Main Results:

  • Overall meta-analysis indicated a statistically significant association between prenatal MAT exposure and lower cognitive development scores (SMD, -0.57).
  • Subanalyses revealed that when controlling for prenatal tobacco exposure, the association between MAT exposure and cognitive scores was no longer significant and became homogeneous.
  • This suggests that maternal tobacco use may confound the observed relationship between MAT and cognitive outcomes.

Conclusions:

  • The initial negative association between prenatal MAT exposure and cognitive development may be influenced by confounding factors, particularly maternal tobacco use.
  • Prioritizing tobacco cessation interventions for pregnant women with opioid use disorder is crucial for improving outcomes in this population.
Abstract

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