The Impact of Prenatal Opioid Exposure on Cognitive, Motor Development

Prenatal opioid exposure may be associated with poorer cognitive and motor development in children from age 6 months to adolescence, according to study results published in JAMA Network Open.

In this systematic review and meta-analysis of 26 studies with 18 unique cohorts, the scores of children who had or had not been exposed to opioids during gestation on standardized cognitive and motor tests appropriate for their respective age groups were analyzed.

In studies in which cognitive tests were used (n=13; 4 common tests; 1455 children with prenatal opioid exposure; 2982 control children); mean age at assessment was 13 months in the toddler group, 4.5 years in the preschool group, and 13 years in the school-aged group. Children with vs without prenatal opioid exposure were found to have lower scores on cognitive tests (standardized mean differences: 0 to 2 years, −0.52; P <.001; 3 to 6 years, −0.38; P <.001), but not at 7 to 18 years (standardized mean difference, −0.44; P =.23).

In studies in which motor testing was conducted (n=14; 6 common tests; 688 children with prenatal opioid exposure, 1500 control children), mean age at assessment was 2 years. Motor scores were found to be lower in children with vs without prenatal opioid exposure (standardized mean differences: 0.49; P <.001).

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Study limitations include significant heterogeneity.

“This systematic review and meta-analysis suggests that prenatal opioid exposure is negatively associated with neurocognitive and motor development. These differences begin from age 6 months and persist in adolescence,” the researchers concluded. “The exact cause and the association of these findings with clinical factors and environmental adversities are unclear but suggest that children with prenatal opioid exposure should be provided long-term support and intervention beyond infancy.”

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Yeoh SL, Eastwood J, et al. Cognitive and motor outcomes of children with prenatal opioid exposure: A systematic review and meta-analysis [published online July 3, 2019]. JAMA Netw Open. doi:10.1001/jamanetworkopen.2019.7025