AUTHOR=Benninger Kristen L. , Borghese Teresa , Kovalcik Jason B. , Moore-Clingenpeel Melissa , Isler Cherie , Bonachea Elizabeth M. , Stark Ann R. , Patrick Stephen W. , Maitre Nathalie L. 

TITLE=Prenatal Exposures Are Associated With Worse Neurodevelopmental Outcomes in Infants With Neonatal Opioid Withdrawal Syndrome

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 8 - 2020

YEAR=2020

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00462

DOI=10.3389/fped.2020.00462

ISSN=2296-2360

ABSTRACT=Aim: To define a developmental trajectory in infants with neonatal opioid withdrawal syndrome (NOWS) and determine whether impacted developmental domain varies with type of antenatal exposure. 
Methods: We performed a retrospective cohort study of infants treated pharmacologically for NOWS and assessed using a standardized schedule for follow-up visits. We compared outcomes of the study population to published norms using one-sample t-tests. Multivariable models examined associations with exposures in addition to opioids.
Results: In our cohort of 285 infants with 9-12 month testing, 164 (55.7%) were seen at 3-4 months, and 125 (44%) at 15-18 months. The majority (58%) had intrauterine drug exposures in addition to opioids. Neurodevelopmental scores of infants with NOWS at 3-4 and 9-12 months were not different from published norms. Cognitive and language scores at 15-18 months were worse than published norms. Male sex, older maternal age and additional barbiturate or alcohol exposure were associated with worse outcomes.
Conclusion: Infants with pharmacologically treated NOWS had development similar to un-exposed infants during the first year but worse cognitive and language scores during the second year. These data support the need for prospective follow-up of large cohorts of infants with NOWS, with systematic assessments and evaluation of contributing factors.