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Early developmental trajectory of children with prenatal alcohol and opioid exposure

Jean R Lowe1, Jared DiDomenico2, Julia M Stephen3

  • 1Department of Pediatrics, School of Medicine, University of New Mexico, Albuquerque, NM, USA.

Pediatric Research
|August 10, 2022
PubMed

Insights

Prenatal exposure to alcohol and opioids negatively impacts infant development, showing declining scores on cognitive and motor assessments. Early and repeated evaluations are crucial for identifying at-risk infants and ensuring proper developmental support.

Area of Science:

  • Neuroscience
  • Developmental Psychology
  • Pediatrics

Background:

  • Increasing rates of opioid use and persistent prenatal alcohol exposure (PAE) necessitate identification of at-risk infants.
  • Prenatal substance exposure can lead to long-term developmental sequelae.
  • The ENRICH-1 prospective cohort study followed maternal-infant pairs to assess developmental outcomes.

Purpose of the Study:

  • To evaluate the impact of prenatal exposure to medications for opioid use disorder (MOUD) and PAE on infant development.
  • To identify specific developmental trajectories in infants exposed to MOUD, PAE, or both, compared to unexposed controls.
  • To assess changes in cognitive, language, and motor skills between 6 and 20 months of age.

Main Methods:

  • Prospective cohort study (ENRICH-1) with four groups: MOUD, PAE, MOUD+PAE, and unexposed controls (UC).
  • Mixed effects modeling was used to analyze changes in Bayley Scales of Infant Development-III (BSID-III) scores.
  • Developmental outcomes were assessed at 6 and 20 months, adjusting for child sex and socioeconomic status.

Main Results:

  • A significant three-way interaction (MOUD-by-PAE-by-Time) was observed for BSID-III Cognitive and Motor scores.
  • Children exposed to MOUD showed changes in Cognitive and Language scores.
  • Children with PAE exhibited changes in Cognitive, Language, and Motor scores; those with MOUD+PAE showed changes in Language scores.
  • Developmental scores remained stable for unexposed controls.

Conclusions:

  • Prenatal alcohol and/or opioid exposure is associated with declining neurodevelopmental scores in early childhood.
  • Standard developmental tests may lack sensitivity in the first year of life.
  • Longitudinal monitoring and repeated evaluations are essential for high-risk infants exposed to polysubstances prenatally.
Abstract

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