Retrospective review of neurodevelopmental outcomes in infants treated for neonatal abstinence syndrome

Abstract

Objective:

Little is known about developmental outcomes in neonatal abstinence syndrome (NAS). We hypothesized that children treated for NAS would score lower than the normative sample on the Bayley Scales of Infant Development, 3rd edition.

Study design:

We performed a retrospective cohort study of 87 infants treated for NAS and evaluated at 2 years of age.

Results:

Children treated for NAS scored significantly lower than the norm (mean 100) on all 3 subscales (cognitive mean 96.5, language mean 93.8, motor mean 94.0, all p < 0.03). Children who lived with foster/adoptive families at follow up had higher cognitive scores (median 100 vs. 95, p = 0.03) than those who lived with biological relatives, and were less likely to have motor scores <85 (p = 0.02). Eight percent of children required treatment for strabismus.

Conclusions:

Children treated for NAS are at risk for lower developmental scores and higher rates of strabismus at age 2 than the general population.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. 1.

    Tolia VN, Patrick SW, Bennett MM, Murthy K, Sousa J, Smith PB, et al. Increasing incidence of the neonatal abstinence syndrome in U.S. neonatal ICUs. N Engl J Med. 2015;372:2118–26.

    Article  Google Scholar 

  2. 2.

    Patrick SW, Schumacher RE, Benneyworth BD, Krans EE, McAllister JM, Davis MM. Neonatal abstinence syndrome and associated health care expenditures: United States, 2000-9. JAMA. 2012;307:1934-40.

  3. 3.

    Hamilton R, McGlone L, MacKinnon JR, Russell HC, Bradnam MS, Mactier H. Ophthalmic, clinical and visual electrophysiological findings in children born to mothers prescribed substitute methadone in pregnancy. Br J Ophthalmol. 2010;94:696–700.

    CAS  Article  Google Scholar 

  4. 4.

    McGlone L, Hamilton R, McCulloch DL, MacKinnon JR, Bradnam M, Mactier H. Visual outcome in infants born to drug-misusing mothers prescribed methadone in pregnancy. Br J Ophthalmol. 2014;98:238–45.

    Article  Google Scholar 

  5. 5.

    McGlone L, Mactier H. Infants of opioid-dependent mothers: neurodevelopment at six months. Early Hum Dev. 2015;91:19–21.

    CAS  Article  Google Scholar 

  6. 6.

    Nygaard E, Moe V, Slinning K, Walhovd KB. Longitudinal cognitive development of children born to mothers with opioid and polysubstance use. Pediatr Res. 2015;78:330–5.

    CAS  Article  Google Scholar 

  7. 7.

    Ornoy A. The impact of intrauterine exposure versus postnatal environment in neurodevelopmental toxicity: long-term neurobehavioral studies in children at risk for developmental disorders. Toxicol Lett. 2003;140-1:171–81.

    Article  Google Scholar 

  8. 8.

    Hunt RW, Tzioumi D, Collins E, Jeffery HE. Adverse neurodevelopmental outcome of infants exposed to opiate in-utero. Early Hum Dev. 2008;84:29–35.

    CAS  Article  Google Scholar 

  9. 9.

    Oei JL, Melhuish E, Uebel H, Azzam N, Breen C, Burns L, et al. Neonatal abstinence syndrome and high school performance. Pediatrics. 2017;139:e20162651.

    Article  Google Scholar 

  10. 10.

    Baldacchino A, Arbuckle K, Petrie DJ, McCowan C. Neurobehavioral consequences of chronic intrauterine opioid exposure in infants and preschool children: a systematic review and meta-analysis. BMC Psychiatry. 2014;14:104.

    Article  Google Scholar 

  11. 11.

    Hall ES, Isemann BT, Wexelblatt SL, Meinzen-Derr J, Wiles JR, Harvey S, et al. A cohort comparison of buprenorphine versus methadone treatment for neonatal abstinence syndrome. J Pediatr. 2016;170:39–44.e31.

    CAS  Article  Google Scholar 

  12. 12.

    Friedman DS, Repka MX, Katz J, Giordano L, Ibironke J, Hawse P, et al. Prevalence of amblyopia and strabismus in white and African American children aged 6 through 71 months the Baltimore Pediatric Eye Disease Study. Ophthalmology. 2009;116:2128–2134.e2121-2122.

    Article  Google Scholar 

  13. 13.

    Sundelin Wahlsten V, Sarman I. Neurobehavioural development of preschool-age children born to addicted mothers given opiate maintenance treatment with buprenorphine during pregnancy. Acta Paediatr. 2013;102:544–9.

    Article  Google Scholar 

  14. 14.

    Sanchez ES, Bigbee JW, Fobbs W, Robinson SE, Sato-Bigbee C. Opioid addiction and pregnancy: perinatal exposure to buprenorphine affects myelination in the developing brain. Glia. 2008;56:1017–27.

    Article  Google Scholar 

  15. 15.

    Vestal-Laborde AA, Eschenroeder AC, Bigbee JW, Robinson SE, Sato-Bigbee C. The opioid system and brain development: effects of methadone on the oligodendrocyte lineage and the early stages of myelination. Dev Neurosci. 2014;36:409–21.

    CAS  Article  Google Scholar 

  16. 16.

    Robinson SE, Maher JR, Wallace MJ, Kunko PM. Perinatal methadone exposure affects dopamine, norepinephrine, and serotonin in the weanling rat. Neurotoxicol Teratol. 1997;19:295–303.

    CAS  Article  Google Scholar 

  17. 17.

    Robinson SE. Effect of prenatal opioid exposure on cholinergic development. J Biomed Sci. 2000;7:253–7.

    CAS  Article  Google Scholar 

  18. 18.

    Luine V, Gomez J, Beck K, Bowman R. Sex differences in chronic stress effects on cognition in rodents. Pharmacol Biochem Behav. 2017;152:13–9.

    CAS  Article  Google Scholar 

  19. 19.

    Samplin E, Ikuta T, Malhotra AK, Szeszko PR, Derosse P. Sex differences in resilience to childhood maltreatment: effects of trauma history on hippocampal volume, general cognition and subclinical psychosis in healthy adults. J Psychiatr Res. 2013;47:1174–9.

    Article  Google Scholar 

  20. 20.

    Bale TL, Epperson CN. Sex differences and stress across the lifespan. Nat Neurosci. 2015;18:1413–20.

    CAS  Article  Google Scholar 

  21. 21.

    Gupta M, Mulvihill AO, Lascaratos G, Fleck BW, George ND. Nystagmus and reduced visual acuity secondary to drug exposure in utero: long-term follow-up. J Pediatr Ophthalmol Strabismus. 2012;49:58–63.

    Article  Google Scholar 

  22. 22.

    Gill AC, Oei J, Lewis NL, Younan N, Kennedy I, Lui K. Strabismus in infants of opiate-dependent mothers. Acta Paediatr. 2003;92:379–85.

    CAS  Article  Google Scholar 

  23. 23.

    Song T, Li G, Liang Z, Tang Y, Yang Y, Xia J, et al. Chronic morphine exposure affects contrast response functions of V1 neurons in cats. Neuroscience. 2012;226:451–8.

    CAS  Article  Google Scholar 

  24. 24.

    Mei B, Niu L, Cao B, Huang D, Zhou Y. Prenatal morphine exposure alters the layer II/III pyramidal neurons morphology in lateral secondary visual cortex of juvenile rats. Synapse. 2009;63:1154–61.

    CAS  Article  Google Scholar 

Download references

Funding

Funding

Source of funding: NIH UG1HD027853-27S1 (Poindexter/Merhar).

Author information

Affiliations

Authors

Corresponding author

Correspondence to Stephanie L. Merhar.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Merhar, S.L., McAllister, J.M., Wedig-Stevie, K.E. et al. Retrospective review of neurodevelopmental outcomes in infants treated for neonatal abstinence syndrome. J Perinatol 38, 587–592 (2018). https://doi.org/10.1038/s41372-018-0088-9

Download citation

Further reading

Search