Association Between Prenatal Opioid Exposure and Neurodevelopmental Outcomes in Early Childhood: A Retrospective Cohort Study.

Autor: Wen X; Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Suite 265F, Kingston, RI, 02881, USA. xuerongwen@uri.edu., Lawal OD; Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Suite 265F, Kingston, RI, 02881, USA., Belviso N; Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Suite 265F, Kingston, RI, 02881, USA., Matson KL; Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Suite 265F, Kingston, RI, 02881, USA., Wang S; Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, 7 Greenhouse Road, Suite 265F, Kingston, RI, 02881, USA., Quilliam BJ; College of Health Sciences, University of Rhode Island, Kingston, RI, USA., Meador KJ; Department of Neurology and Neurological Sciences, Stanford University School of Medicine, California, CA, USA.
Jazyk: angličtina
Zdroj: Drug safety [Drug Saf] 2021 Aug; Vol. 44 (8), pp. 863-875. Date of Electronic Publication: 2021 Jun 07.
DOI: 10.1007/s40264-021-01080-0
Abstrakt: Introduction: Several studies have reported increasing prevalence of prescription opioid use among pregnant women. However, little is known regarding the effects of maternal opioid use on neurodevelopmental disorders in early childhood in pregnant women with no evidence of opioid use disorders or drug dependence.
Objective: The aim of this study was to quantify the association between prenatal opioid exposure from maternal prescription use and neurodevelopmental outcomes in early childhood.
Methods: This retrospective study included pregnant women aged 12-55 years and their live-birth infants born from 2010 to 2012 present in Optum's deidentified Clinformatics® Data Mart database. Eligible infants born to mothers without opioid use disorders or drug dependence were followed till occurrence of neurodevelopmental disorders, loss to follow-up, or study end (December 31, 2017), whichever came first. Propensity score by fine stratification was applied to adjust for confounding by demographic characteristics, obstetric characteristics, maternal comorbid mental and pain conditions, and measures of burden of illnesses and to obtain adjusted hazard ratios (HR) and 95% confidence intervals (CI). Exposed and unexposed infants were compared on the incidence of neurodevelopmental disorders.
Results: Of 24,910 newborns, 7.6% (1899) were prenatally exposed to prescription opioids. Overall, 1562 children were diagnosed with neurodevelopmental disorders, with crude incidence rates of 2.9 per 100 person-years in exposed children versus 2.5 per 100 person-years in unexposed children. After adjustment, we observed no association between fetal opioid exposure and the risk of neurodevelopmental disorders (HR 1.10; 95% CI 0.92-1.32). However, increased risk of neurodevelopmental disorders were observed in children with longer cumulative exposure duration (HR 1.70; 95% CI 1.05-2.96) or high cumulative opioid doses (HR 1.22; 95% CI 1.01-1.54).
Conclusion and Relevance: In pregnant women without opioid use disorders or drug dependence, maternal opioid use was not associated with increased risk of neurodevelopmental disorders in early childhood. However, increased risks of early neurodevelopmental disorders were observed in children born to women receiving prescription opioids for longer duration and at higher doses during pregnancy.
(© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze: MEDLINE
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