Prenatal Opioid Exposure and Risk for Adverse Brain and Motor Outcomes in Infants Born Premature.
J Pediatr
; 267: 113908, 2024 Apr.
Article
em En
| MEDLINE
| ID: mdl-38220065
ABSTRACT
OBJECTIVE:
To compare brain magnetic resonance imaging (MRI) biomarkers and neurodevelopmental test scores in infants born preterm with and without prenatal opioid exposure (POE). STUDYDESIGN:
We examined 395 preterm infants (≤32 weeks gestational age) who had term-equivalent brain MRIs, composite scores from the Bayley Scales of Infant and Toddler Development-III at 2 years corrected age, and POE data. MRI parameters included total/regional brain volumes and severe punctate white matter lesions (PWMLs). We conducted bivariable analysis and multivariable logistic regression analyses.RESULTS:
The mean ± SD gestational age was 29.3 ± 2.5 weeks; 35 (8.9%) had POE and 20 (5.1%) had severe PWML. Compared with unexposed infants, those with POE exhibited higher rates of severe PWML (17.1% vs 3.9%, respectively; P = .002); findings remained significant with an OR of 4.16 (95% CI, 1.26-13.68) after adjusting for confounders. On mediation analysis, the significant relationship between POE and severe PWML was not indirectly mediated through preterm birth/gestational age (OR, 0.93; 95% CI, 0.78-1.10), thus suggesting the association was largely driven by a direct adverse effect of POE on white matter. In multivariable analyses, POE was associated with a significantly lower score by -6.2 (95% CI, -11.8 to -0.6) points on the Bayley Scales of Infant and Toddler Development-III Motor subscale compared with unexposed infants.CONCLUSIONS:
POE was associated with severe PWML; this outcome may be a direct effect of POE rather than being mediated by premature birth. POE was also associated with worse motor development. Continued follow-up to understand the long-term effects of POE is warranted.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Nascimento Prematuro
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Substância Branca
Tipo de estudo:
Etiology_studies
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Risk_factors_studies
Limite:
Child, preschool
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Female
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Humans
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Infant
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Newborn
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Pregnancy
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article