Cognitive and motor outcomes of children with prenatal opioid exposure: a systematic review and meta-analysis

Yeoh, Su Lynn, Eastwood, John, Wright, Ian M., Morton, Rachael, Melhuish, Edward, Ward, Meredith, and Oei, Ju Lee (2019) Cognitive and motor outcomes of children with prenatal opioid exposure: a systematic review and meta-analysis. JAMA Network Open, 2 (7). e197025.

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Importance: Prenatal opioid exposure (POE) is one of the fastest-growing global health problems, but its association with long-term neurologic and physical development remains unknown.

Objective: To assess the association between POE and cognitive and motor development in children from age 6 months to 18 years.

Data Sources: Key search terms included prenatal opioid exposure, neonatal abstinence syndrome, and neurocognitive development. Studies were searched using PubMed and Embase, with no publication date restriction, through August 20, 2018.

Study Selection: Only published cohort studies comparing the results of age-appropriate standardized cognitive and/or motor tests between children with any POE (aged 0-18 years) with drug-free controls were included. Data that were not convertible to means and SDs were excluded.

Data Extraction and Synthesis: This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Data were pooled using a random-effects model.

Main Outcomes and Measures: Standardized mean difference of cognitive and motor tests between POE and nonexposed children.

Results: Twenty-six peer-reviewed cohort studies were included. Cognitive outcomes were compared for a total of 1455 children with POE and 2982 nonexposed children across 3 age groups (mean [SE] age at cognitive testing was 13 [1.58] months for the toddler group; 4.5 [0.38] years for the preschool group; and 13 [2.36] years for the school-aged group). Motor outcomes were compared for 688 children with POE and 1500 nonexposed children up to age 6 years (mean [SD] age at motor testing, 2 [0.45] years). Standardized mean difference was lower in cognitive tests for children with POE at 0 to 2 years (d = -0.52; 95% CI, -0.74 to -0.31; P <.001) and 3 to 6 years (d = -0.38; 95% CI, -0.69 to -0.07; P <.001); the difference was not significant for those aged 7 to 18 years (d = -0.44; 95% CI, -1.16 to 0.28; P =.23). Motor scores were lower in children with POE (d = 0.49; 95% CI, 0.23-0.74; P <.001).

Conclusions and Relevance: Prenatal opioid exposure appeared to be negatively associated with neurocognitive and physical development from age 6 months, and this association persisted until adolescence. The cause and association of this with POE or other factors (eg, withdrawal treatment) are uncertain but suggest that POE necessitates long-term support and intervention.

Item ID: 62778
Item Type: Article (Research - C1)
ISSN: 2574-3805
Copyright Information: Open Access. This is an open access article distributed under the terms of the CC-BY License. © 2019 Yeoh SL et al. JAMA Network Open.
Date Deposited: 17 May 2020 23:22
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3213 Paediatrics > 321302 Infant and child health @ 50%
52 PSYCHOLOGY > 5204 Cognitive and computational psychology > 520401 Cognition @ 50%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920501 Child Health @ 50%
97 EXPANDING KNOWLEDGE > 970111 Expanding Knowledge in the Medical and Health Sciences @ 50%
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