Cognitive and Behavioral Impact on Children Exposed to Opioids During Pregnancy
Cognitive and Behavioral Impact on Children Exposed to Opioids During Pregnancy
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DOI：
10.1542/peds.2019-0514
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发表时间：
2019-08-01
期刊：
影响因子：
8
通讯作者：
Bada, Henrietta S.
中科院分区：
文献类型：
--
作者：
Larson, Justine J.;Graham, Devon L.;Bada, Henrietta S.
怀孕期间接触阿片类药物对儿童的影响是一个争论的话题，但它是不良后果风险的一个标志。怀孕期间使用阿片类药物对发育的影响是一个持续争论的话题。短期新生儿结局，例如低出生体重和新生儿戒断综合征，是最受认可的结局。然而，关于长期神经认知和心理健康结果存在知识差距。在本文中，我们总结了药物滥用和心理健康服务管理局于 2018 年 4 月举行的一次专家小组讨论会，与会者包括围产期阿片类药物暴露及其对儿童发育影响领域的国家专家。尽管该领域的研究面临挑战，但不断有文献揭示，子宫内接触阿片类药物的新生儿与长期不良神经认知、行为和发育结果之间存在关联。尽管不良后遗症在新生儿期可能并不明显，但随着儿童发育并达到学龄前和学龄期，它们可能会变得更加明显。多个变量（遗传、环境和生物）导致了高度复杂的情况。探讨了支持受阿片类药物使用障碍影响的家庭的后续步骤和策略。还考虑了示范项目，包括对儿童和母亲的综合护理、育儿支持以及加强家访。
The impact on children exposed to opioids during pregnancy is a subject of debate, but it is a marker for risk of adverse outcomes.The developmental impact of opioid use during pregnancy is a subject of ongoing debate. Short-term neonatal outcomes, such as lower birth weight and neonatal abstinence syndrome, are the most well-recognized outcomes. However, knowledge gaps exist regarding longer-term neurocognitive and mental health outcomes. In this article, we summarize an expert panel discussion that was held in April 2018 by the Substance Abuse and Mental Health Services Administration and attended by national experts in the field of perinatal opioid exposure and its impact on child development. Despite the challenges with research in this area, there is emerging literature revealing an association between neonates exposed to opioids in utero and longer-term adverse neurocognitive, behavioral, and developmental outcomes. Although adverse sequalae may not be apparent in the neonatal period, they may become more salient as children develop and reach preschool and school age. Multiple variables (genetic, environmental, and biological) result in a highly complex picture. The next steps and strategies to support families impacted by opioid use disorder are explored. Model programs are also considered, including integrated care for the child and mother, parenting supports, and augmentations to home visiting.