TDNet Discover

Background: Opioid use disorder (OUD) has increased in prevalence in the United States, with individuals reporting misuse of opioids during pregnancy and labor quadrupling between the years of 1999 and 2014. Medications for opioid use disorder (MOUD) have become the standard of treatment, with medications such as methadone and buprenorphine helping to relieve the symptoms of addiction and reduce overall substance misuse. MOUD has begun to be utilized during the pregnancy interval to reduce pregnant individuals’ symptoms of addiction, prevent continued and increased misuse of opioids, and prevent the development of neonatal abstinence syndrome (NAS). NAS occurs due to the use of substances during the process of pregnancy where the child is exposed to such substances and subsequently withdraws after birth. Current research into the long-term complications of MOUD in the developmental processes of children is sparse. Purpose: To determine how MOUD and opioid exposure prenatally affect the development of children throughout childhood. Methods: An evidence-based clinical review (EBCR) was conducted to discover 3 studies with the highest level of evidence and good quality. Multiple databases were utilized in the literature search that properly applied to the predetermined criteria. Articles were then evaluated for quality of the study, type of study design, and quantity of evidence contained within. A data extraction tool was utilized to perform qualitative analyses of included articles. Results: Children exposed to prenatal MOUD and opioid use were found to have lower cognitive scores (-0.77 to -4.43), lower psychomotor scores (-0.49 to -5.42), and higher scores for internalizing (0.42), externalizing (0.66), and attention problems (0.72) than their unexposed peers. v Conclusion: Exposure to opioid and MOUD use was found to cause a significant delay in cognition, psychomotor, and social-emotional development of children. Providers must weigh the risk of harm of pregnant individuals continuing to misuse opioids versus the harm of MOUD exposure during pregnancy to the development of the child.