Adverse neurodevelopmental outcome of infants exposed to opiate in-utero

Abstract

In-utero drug exposure is associated with increased risks of perinatal morbidity and mortality, however longer term neurodevelopmental outcome of survivors is poorly described. Aims: The aims of this paper are: (1) to review the published literature which examines neurodevelopmental outcome in infants with Neonatal Abstinence Syndrome (NAS) and (2) to report developmental follow-up data from a case-control study of babies exposed to opiate in-utero. Methods: This study was conducted at Royal Prince Alfred Hospital in Sydney, NSW, through the multidisciplinary NAS service. Literature was reviewed after searching MEDLINE for relevant studies. Our own case-control study was conducted to examine neurodevelopmental outcome. A number of standardized neuropsychological tools were employed to assess these infants. Results: Results from previously published studies on outcome of infants with NAS were not reassuring as to reported ‘normal development’. In our own case-control study, opiate-exposed infants were significantly more likely to have neurodevelopmental impairment compared to healthy control infants, when assessed at 18 months and 3 years of age. Conclusions: Infants exposed to opiates in-utero are at increased risk of neurodevelopmental problems throughout early childhood.