P3B347: Impact of In-utero Opioid Exposure on Social-emotional Development over Time

Background:

Background: The current body of research has shown that children exposed in-utero to drugs are at risk for unfavorable outcomes in health and development. Medication-assisted-therapy, which involves taking opioids, is regularly used during pregnancy for treatment of opioid use disorder; however, the association of in-utero opioid exposure with progression of social and emotional development is not yet well-understood. The goal of this study was to examine social and emotional development during the first two years of life in children prenatally exposed to opioids.

Methods:

Methods: Participants in this study were children who received medical care at a university-affiliated pediatric clinic. Of the 65 non-opioid-exposed and 51 opioid-exposed patients, none had known exposure to alcohol or illicit drugs, with substance use status biochemically confirmed. Of the 51 exposed children, 24 were born to mothers receiving medication-assisted treatment for opioid misuse. In addition to background information, Ages and Stages Questionnaire: Social-Emotional (ASQ-SE) developmental screening results, in which higher scores indicate greater developmental delay, were extracted from the medical records for well-child visits at 6, 12, and 24 months of age.

Results:

Results: The opioid-exposed group was significantly more likely to be white non-Hispanic, have older mothers, and have more siblings than the unexposed group. After controlling for these differences,
opioid-exposed children did not differ significantly from controls at six months of age in total ASQ-SE score or percent in the highest quartile. However, at 12 months, the exposed group had a significantly higher average ASQ-SE score (adjusted mean difference=10; 95% CI 0.3-19.7). By 24 months, the adjusted mean difference had increased (12.0 (1.2-22.8)), and compared to controls, the opioid exposed group had a more than four-fold increased risk of having ASQ-SE scores in the highest quartile (OR=4.56 (1.29-16.11)).

Conclusion:

Conclusions: Despite a somewhat small sample size, in-utero opioid exposure predicted social-emotional delays at 12 and 24 months of age in this study. This suggests that although differences may not be evident earlier in infancy, opioid exposure poses considerable risk for negative effects on social-emotional development that become apparent with age. The findings add to the current body of knowledge about effects of prenatal opioid exposure on long-term social-emotional development. This study also demonstrates how physicians can easily assess exposed children for delays in development, specifically at certain well-child visits, in the context of an easy and quick-to-administer screener, the ASQ-SE, and similar tools used in clinical care.