Poster #79 - Neurodevelopmental consequences of prenatal opioid exposure: A pilot study

• In Event: 2-002 - Special Poster Session 05 with Continental Breakfast Reception
  In Poster Session: PS 05 - Interdisciplinary Section

Integrative Statement

Introduction: From 2000 to 2009, opioid use among pregnant women in the US tripled with a parallel increase in the incidence of neonatal opioid withdrawal syndrome (NOWS; Holmes, Atwood, Whalen, Beliveau, Jarvis, Matulis, Ralston, 2016; Ko, Patrick, Tong, Patel, Lind, & Barfield, 2016). NOWS, also known as neonatal abstinence syndrome, is a drug withdrawal syndrome characterized by irritability, tremors, feeding intolerance, watery stools, and respiratory difficulties (Sutter, Leeman, & His, 2014). There are few studies which assess the neurodevelopmental outcomes of children with prenatal opioid exposure that include a sociodemographically-matched control group. This information is critical for determining whether prenatal opioid exposure impacts newborn neurobehavioral outcomes above and beyond associated risk factors such as prenatal maternal mood disorder and socioeconomic status.
Hypothesis: Newborns exposed to opioids prenatally will exhibit impaired newborn neurobehavioral outcomes compared to a matched, unexposed, control group.
Study population: Infants with prenatal opioid exposure (n = 4, target N = 20) were recruited in a specialty prenatal clinic for pregnant and postpartum women with substance use disorders. We compared newborn neurobehavioral outcomes to a matched, unexposed control group (n = 4) recruited as part of an NIMH-funded study on prenatal exposure to maternal emotion dysregulation on newborn neurobehavior. We are on track to recruiting our target sample size by January, 2019.
Method: Trained examiners conducted the NICU Network Neurobehavioral Scale (NNNS; Lester & Tronick, 2002). The NNNS is a widely used, standardized, validated, comprehensive tool used to assess newborn neurobehavior. Summary scores includes infant attention, self-regulation, arousal, hypertonicity, hypotonicity, and lethargy. The NNNS long-term predictive validity suggests a connection between newborn neurobehavior and below average IQ, problems with adaptive behavior, and risk for problem behavior (Liu et al., 2010).
Results: We matched exposed (n = 4, target N = 20) and unexposed (n = 4, target N = 20) newborns on infant sex, birth weight, and gestational age. There were no significant differences between the groups on these variables, all p’s >.58. There were no significant differences between the exposure groups on any of the NNNS outcomes (Table 1). As a reference, we also include means and standard deviations for an unexposed, high SES, normative control group (Tronick, Olson, Rosenberg, Bohne, Liu, & Lester, 2004). Infants had consistently higher attention, self-regulation, and lethargy, and lower arousal, hypertonia, and hypotonia, if they were in the unmatched, unexposed, high SES control group.
Conclusions: It is important to control for relevant confounds, such as prenatal exposure to maternal stress and emotion dysregulation when evaluating the neurobehavioral consequences of prenatal opioid exposure. Our current data are limited by small sample sizes. Recruitment is ongoing and we expect to meet our target sample size of N = 40 (20 per group) by January, 2019.

Authors

• Elisabeth Conradt, University of Utah
  Presenting Author

• Sarah Priddy, University of Utah
  Non-Presenting Author

• Celine Saenz, University of Utah
  Non-Presenting Author

• Marcela Smid, University of Utah
  Non-Presenting Author

• Julie Shakib, University of Utah
  Non-Presenting Author

• Camille Fung, University of Utah
  Non-Presenting Author

• Karen Buchi, University of Utah
  Non-Presenting Author

• Eric Garland, University of Utah
  Non-Presenting Author

• Sheila Crowell, University of Utah
  Non-Presenting Author