Abstract
Increasing evidence suggests that prenatal exposure to opioids may affect brain development, but limited data exist on the effects of opioid-exposure on preschool language development. Our study aimed to characterize the nature and prevalence of language problems in children prenatally exposed to opioids, and the factors that support or hinder language acquisition. A sample of 100 children born to pregnant women in methadone maintenance treatment and 110 randomly identified non-exposed children were studied from birth to age 4.5 years. At 4.5 years, 89 opioid-exposed and 103 non-exposed children completed the preschool version of the Clinical Evaluation of Language Fundamentals (CELF-P) as part of a comprehensive neurodevelopmental assessment. Children prenatally exposed to opioids had poorer receptive and expressive language outcomes at age 4.5 years compared to non-opioid exposed children. After adjustment for child sex, maternal education, other pregnancy substance use, maternal pregnancy nutrition and prenatal depression, opioid exposure remained a significant independent predictor of children’s total CELF-P language score. Examination of a range of potential intervening factors showed that a composite measure of the quality of parenting and home environment at age 18 months and early childhood education participation at 4.5 years were important positive mediators.
Highlights
The use of prescribed and illicit opioids has increased dramatically in the last decade, in the US, and more recently in Australia, New Zealand and Europe [1,2,3,4,5].As a consequence, opioid use during pregnancy has increased which is concerning given the importance of the intrauterine environment for fetal and child development [6,7].there has been growing interest in the effects of prenatal opioid exposure and other correlated pre and postnatal risk factors on both the short- and long-term outcomes for children born to women with an opioid use disorder (OUD)
Study findings demonstrate that women treated with methadone for an OUD are characterized by multiple risk factors that at least in part contribute to the poorer preschool language outcomes of their children
Our findings show that positive postnatal factors such as sensitive parenting, enriched cultural environment and ECE can to some extent reduce the adverse effects of prenatal opioid exposure on preschool language development
Summary
Opioid use during pregnancy has increased which is concerning given the importance of the intrauterine environment for fetal and child development [6,7]. There has been growing interest in the effects of prenatal opioid exposure and other correlated pre and postnatal risk factors on both the short- and long-term outcomes for children born to women with an opioid use disorder (OUD). Existing evidence suggests increased risks for a range of adverse neonatal outcomes, including poorer fetal growth and Neonatal Abstinence Syndrome, as well as the possibility that child risks may extend into early and middle childhood [3,8,9,10,11,12,13]. Language acquisition is an important developmental milestone during the early childhood years [15].
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