Abstract
Opioid use disorder (OUD) among pregnant women over the last decade has led to more than a fivefold increase in the number of neonates born with withdrawal signs known as Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS). The impact of prenatal opioid exposure on these neonates remains a public health and research priority due to both its short and long-term effects on offspring. Among the adverse long-term effects associated with OUD is a metabolic syndrome with accompanying cardiovascular comorbidities. The susceptibility to metabolic diseases may begin as early as conception. Neonates born in a setting of prenatal opioid exposure are known to have aberrant early growth, e.g., lower birth weight and smaller head size, and dysregulated feeding behavior that ranges from feeding difficulty to hyperphagia which may predispose these neonates to metabolic syndrome in adulthood. However, studies on this topic are lacking. In this article, we describe the reported association between OUD and metabolic syndrome in adults, animal data linking opioid receptors with the development of diet-induced obesity, the inflammatory modulation of opioids and finally, neonatal salivary transcriptomic data from our laboratory that highlighted the sex-specific impact of opioids on the hypothalamic and reward receptors that regulate feeding behavior in opioid-exposed neonates. There is a great need for future research linking opioids with epigenetic and gene expression changes, as well as neuromodulatory effects in the developing brain, that may underlie the dysregulated feeding, growth, and long-term metabolic and cardiovascular risks for these neonates.
Highlights
The rate of pregnant women misusing opioids has quadrupled between 1999 and 2014 [1], leading to a fivefold increase in Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS) in the last decade [2]
While limited by the small number of subjects and duration, our study provided the foundation for an ongoing study examining the sex-specific impact of prenatal opioid exposure in a larger cohort and beyond the hospital stay
Animal and human studies highlight the intricate and complex intersection between reward and feeding receptors in the brain, as well as central and peripheral inflammation that may explain the linkage between Opioid use disorder (OUD) and metabolic syndrome
Summary
The rate of pregnant women misusing opioids has quadrupled between 1999 and 2014 [1], leading to a fivefold increase in Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS) in the last decade [2]. The exact mechanisms by which drug addiction and metabolic syndrome are linked together are of growing interest, with some reporting no direct association [9], while others reporting disrupted reward circuitry, i.e., dopamine receptors, as a common denominator between opioid addiction, food dependence and obesity [10,11,12]. To close this knowledge gap, our laboratory examines the expression of hypothalamic and reward genes that regulate feeding behavior in opioidexposed neonates, with evidence of abnormal reward signaling and behavioral changes that may predispose these neonates to long-term growth and metabolic issues [13]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
