Prenatal opioid exposure (POE) is negatively associated with neurocognitive and physical development in offspring from the age of 6 months into school age, according to a study published online in JAMA Network Open.

Su Lynn Yeoh, from the University of New South Wales in Sydney, and colleagues reviewed data from 26 peer-reviewed cohort studies to examine the correlation between POE and cognitive and motor development in children aged 6 months to 18 years. Cognitive outcomes were compared for 1,455 children with POE and 2,982 nonexposed children across three age groups (mean age at cognitive testing, 13 months, 4.5 years, and 13 years for the toddler, preschool, and school-aged groups, respectively). For 688 children with POE and 1,500 nonexposed children up to age 6 years, motor outcomes were compared.

The researchers found that the standardized mean difference in cognitive tests was lower for children with POE at 0 to 2 years and 3 to 6 years (d, −0.52 [95 percent confidence interval (CI), −0.74 to −0.31; P < 0.001] and −0.38 [95 percent CI, −0.69 to −0.07; P < 0.001], respectively); for those aged 7 to 18 years, the difference was not significant (d, −0.44; 95 percent CI, −1.16 to 0.28; P = 0.23). Children with POE had significantly lower motor scores (d, −0.49; 95 percent CI, −0.74 to −0.23; P < 0.001).

"The exact cause and the association of these findings with clinical factors and environmental adversities are unclear but suggest that children with POE should be provided long-term support and intervention beyond infancy," the authors write.

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