Abstract
An increasing consumption of opioids has been reported. The primary aim of the present study was follow-up of neurocognitive development in children exposed to analgesic opioids during pregnancy, using three different validated instruments to assess language and communication development at 5 years. The Norwegian Mother and Child Cohort Study (MoBa) prospectively included pregnant women 1999 to 2008. Participants reported medication use at pregnancy week 17/18 and 30, and 6 months after birth. Children's language competence and communication skills at 5 years were reported by mothers on three different validated scales; The Ages and Stages Questionnaire (ASQ), The Speech and Language Assessment Scale (SLAS) and The Twenty Statements about Language-Related Difficulties list (Language20Q). A total of 27 428 women with 33 407 singleton pregnancies were included. Use of analgesic opioids was reported in 584 pregnancies (1.7%). No associations between opioid use and lower language competence or communication skills were found. For ASQ, the OR of being in the lowest category vs the group with maximum mean score was 0.82 (95%CI 0.57, 1.17), for SLAS the OR of scoring worse than typical for age vs better than typical for age was 0.84 (0.61, 1.17) in children exposed to opioids in utero. For Language20Q using the best performance category as reference, the OR of scoring in the lower performance category was 0.57 (0.35, 0.91) with exposure to opioids. Use of analgesic opioids in pregnant women does not seem to negatively affect language development or communication skills in children at 5 years.
Highlights
A remarkable increase in use of opioid analgesics during the last two decades has been documented in the general population worldwide [1,2,3,4,5,6]
There were no trends towards an effect of analgesic opioids at three years it was considered important to strengthen the conclusion by studying language and communication development in the same cohort at a later stage using other validated instruments
Some of the information in MoBa is obtained by linkage to the Medical Birth Registry of Norway (MBRN) which is a nationwide registry based on mandatory notification of all births or late abortions in Norway [33]
Summary
A remarkable increase in use of opioid analgesics during the last two decades has been documented in the general population worldwide [1,2,3,4,5,6]. No increasing trend in analgesic opioid use is so far observed in the population of pregnant women in Norway [18, 19], it is important to gain knowledge on potential harmful effects to the offspring. In a previous study on language competence and communication skills in 3-year old children no association with prenatal exposure to analgesic opioids was found [25]. There were no trends towards an effect of analgesic opioids at three years it was considered important to strengthen the conclusion by studying language and communication development in the same cohort at a later stage (five years) using other validated instruments. The aim of the present study was to assess the effect of exposure to analgesic opioids during pregnancy on development of language and communication skills in 5-year old children
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