Exposure to opioids during pregnancy could be causing long-term, unknown health conditions for a generation of children, a University of Dundee expert has warned.
Dr Louise Marryat, an expert in infant health at the University’s School of Health Sciences, says there is an urgent need for greater knowledge of how exposure to substances such as fentanyl, heroin, and a multitude of prescription painkillers in the womb impact the health and development of children.
It follows a new, comprehensive review of previous studies by a team led by Dr Marryat, which found evidence that children exposed to opioids when in the womb were at increased risk of impediments to their visual function, motor skills, behavioural problems and language difficulties. However, Dr Marryat and her team have identified an urgent need for further research to determine if additional factors may also be contributing to negative health outcomes.
Multiple studies have looked at the impact of opioid exposure on different areas of child development. However, single study evidence has often been inhibited by the small number of participants. By bringing together and analysing 478 individual papers, the Dundee team has, for the first time, been able to provide a comprehensive assessment of opioid use on prenatal child development. The findings have been published in the journal BMJ Paediatrics Open.
“We need to provide healthcare providers, government, and parents with the information that is needed to ensure that countless numbers of children receive the information and support they deserve,” said Dr Marryat.
“Women who use opioids in pregnancy overwhelmingly want the best for their children. During pregnancy, the focus for mothers is very much on having a healthy baby. These are fundamental and understandable concerns but focus less on the long-term outcomes of the child, even when exposed to opioids.
“Our umbrella review has highlighted evidence of adverse impacts in both cognitive and motor skills, as well as visual impairments and behavioural difficulties in exposed children. However, we do need further research to address gaps in our knowledge. This is crucial to ensure that parents, healthcare providers and policy makers have the information they need to make decisions that could safeguard the wellbeing of these children.”
The team’s review looked at outcomes beyond six weeks postpartum until preschool age. However, beyond its main findings the research team concede that longer-term impacts remain inadequately researched, with little evidence available to inform health practice or guide government policy.
“We need better quality evidence around this area that takes into account all of the other factors that play a role in these children’s lives,” added Dr Marryat.
“That would allow us to determine the extent to which opioid exposure, and the different types of opioids, are responsible for these outcomes.
“A lot of studies we looked at didn’t account for the education of the parents, whether the child attended nursery, or whether the family was living in poverty, which we know are hugely impactful on a child’s development. Sample sizes were also quite small.
“There is a particular shortage of research conducted on children exposed to opioids. These parents may have a mistrust of the healthcare system due to previous experiences. Many fear that their children may be removed from their care. There needs to be appropriate pathways providing services that work alongside parents to fully support children and families in challenges they might face, but that is not easy when many services are already stretched.”
The full findings can be read in the journal BMJ Paediatrics Open. You can read more about Dr Marryat’s research online.