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Aberrant Feeding and Growth in Neonates With Prenatal Opioid Exposure: Evidence of Neuromodulation and Behavioral
Elizabeth Yen1,2, Jill L Maron3,4
1Mother Infant Research Institute, Tufts Medical Center, Boston, MA, United States.
Insights
Prenatal opioid exposure increases Neonatal Abstinence Syndrome (NAS/NOWS) risk. This exposure may lead to long-term metabolic syndrome and cardiovascular issues in neonates, highlighting a critical need for further research.
Area of Science:
- Reproductive Medicine
- Neonatal Health
- Metabolic Disorders
Background:
- Opioid use disorder (OUD) in pregnant women has surged, increasing Neonatal Abstinence Syndrome (NAS/NOWS) cases.
- Prenatal opioid exposure poses significant short- and long-term risks to neonates, including metabolic syndrome and cardiovascular comorbidities.
- Metabolic disease susceptibility may originate in utero, with prenatal opioid exposure linked to aberrant neonatal growth and feeding behaviors.
Purpose of the Study:
- To explore the association between OUD and metabolic syndrome.
- To review animal data on opioid receptors and obesity.
- To present preliminary neonatal salivary transcriptomic data on sex-specific opioid effects on feeding regulation.
Main Methods:
- Literature review of OUD and metabolic syndrome in adults.
- Analysis of animal studies linking opioid receptors to obesity.
- Examination of neonatal salivary transcriptomic data from an in-house laboratory.
Main Results:
- OUD is associated with metabolic syndrome and cardiovascular issues in adults.
- Opioid receptors are implicated in diet-induced obesity in animal models.
- Neonatal salivary transcriptomics revealed sex-specific opioid impacts on hypothalamic and reward pathways regulating feeding.
Conclusions:
- Prenatal opioid exposure may predispose neonates to adult metabolic syndrome and cardiovascular risks.
- Further research is crucial to understand the epigenetic, gene expression, and neuromodulatory mechanisms underlying these risks.
- Investigating these mechanisms is vital for developing targeted interventions for affected neonates.
Abstract:
Opioid use disorder (OUD) among pregnant women over the last decade has led to more than a fivefold increase in the number of neonates born with withdrawal signs known as Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS). The impact of prenatal opioid exposure on these neonates remains a public health and research priority due to both its short and long-term effects on offspring. Among the adverse long-term effects associated with OUD is a metabolic syndrome with accompanying cardiovascular comorbidities. The susceptibility to metabolic diseases may begin as early as conception. Neonates born in a setting of prenatal opioid exposure are known to have aberrant early growth, e.g., lower birth weight and smaller head size, and dysregulated feeding behavior that ranges from feeding difficulty to hyperphagia which may predispose these neonates to metabolic syndrome in adulthood. However, studies on this topic are lacking. In this article, we describe the reported association between OUD and metabolic syndrome in adults, animal data linking opioid receptors with the development of diet-induced obesity, the inflammatory modulation of opioids and finally, neonatal salivary transcriptomic data from our laboratory that highlighted the sex-specific impact of opioids on the hypothalamic and reward receptors that regulate feeding behavior in opioid-exposed neonates. There is a great need for future research linking opioids with epigenetic and gene expression changes, as well as neuromodulatory effects in the developing brain, that may underlie the dysregulated feeding, growth, and long-term metabolic and cardiovascular risks for these neonates.
