Cognitive and Motor Outcomes of Children With Prenatal Opioid Exposure

• A systematic review and meta-analysis that studied the association between prenatal opioid exposure (POE) on cognitive and motor development in children from age 6 months to 18 years 
• Out of the 26 studies included, 1,455 children with POE and 2,982 controls were included. Children were all from high income countries and regions, including the United States, Australia, Europe, and Israel. Children were born between 1970 and 2004.
• Illicit drugs ingested (polydrug use) included Heroin in 10 studies, methadone in 13 studies, and unspecified opioids ingestion in 3 studies.
• Cognitive and motor tests that were used included the Bayley Scales of Infant Development, Griffiths Mental Development Scales, Weschler Preschool and Primary Scale of Intelligence, Snijders Oomen Nonverbal Intelligence tests, and the Merrill Palmer Scale of Mental Tests. 
• For infants ages 0-24 months, 13 studies with 584 children with POE and 1,496 controls showed a significant difference in neurocognitive development. Cognitive and motor development results for children with POE were lower than those children in the control group. For children ages 3-6 years, 13 studies with 719 children with POE compared with 1,346 controls also revealed a significant difference in neurocognitive development. Children ages 7-18 years with 152 children with POE compared with the control group (140) showed a difference in neurocognitive development that was not significant. 
• Motor outcomes showed that 688 children aged 6 years and younger with POE compared with 1,500 in the control group showed a decrease in motor development. 
• These studies concluded that POE has a negative association with cognitive and motor outcomes, and can be seen as early as 6 months and persist through school age. Researchers stated that 6.3% of children with POE will have an IQ score 2 SD below normal compared with 2.3% of children in a normal population. 
• This suggests that children with POE are 3 times more likely to have intellectual disabilities according to the Diagnostic and Statistical Manual of Mental Disorders. 
• This may be related to being vulnerable in their living situation, and a higher risk of neglect and abuse. It can also put them at higher risk to have behavioral and attention deficits, leading to poorer academic, social and lifestyle outcomes. 
• The exact cause and association of these findings are unclear but it suggests that children with POE should be given long term support and intervention.

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