Discipline of Psychiatry, University of Western Australia, Sir Charles Gairdner Hospital, Nedlands, Western Australian.
School of Population and Global Health, University of Western Australia, Crawley, Western Australian.
Am J Addict. 2017 Dec;26(8):845-851. doi: 10.1111/ajad.12642. Epub 2017 Nov 16.
Little is known about the health of children exposed to opioid pharmacotherapies in utero. This study aims to examine the health of children from birth to 5 years of age, who were exposed to methadone, buprenorphine, or naltrexone with non-exposed children.
Children were identified by linking the treatment records of women treated with one of the three opioid pharmacotherapies with midwife notifications. Live-born children exposed to methadone (n = 198), buprenorphine (n = 122), naltrexone (n = 67) in utero, and neonates not prenatally exposed to opioids (n = 387) born between 2001 and 2011 in Western Australia were included in the study. The children were then linked to state mortality, hospital, emergency department (ED), mental health, cancer, and reportable diseases from birth up to their 5th birthday.
Overall rates of hospital admission were elevated in all three treatments as compared with the control children, while rates of ED attendances were only significantly elevated in the methadone (p = .002) and naltrexone (p = .044) exposed children. In terms of both hospital and ED attendances, the differences between the exposed and control children was most apparent in the neonatal period. Rates of mental health out-patient attendances were elevated in buprenorphine-exposed children as compared with the control (p = .005).
The study provides evidence to suggest a disparity in the health of children exposed to opioid pharmacotherapies in utero compared with non-exposed control children.
Exposure to opioid pharmacotherapies in utero may influence the health of children beyond the neonatal period. (Am J Addict 2017;26:845-851).
人们对于子宫内暴露于阿片类药物治疗的儿童的健康状况知之甚少。本研究旨在检查从出生到 5 岁的儿童的健康状况，这些儿童暴露于美沙酮、丁丙诺啡或纳曲酮，而非暴露于阿片类药物的儿童为对照组。
通过将接受三种阿片类药物治疗之一的女性的治疗记录与助产士的通知相联系，确定活产儿童的身份。2001 年至 2011 年期间，在澳大利亚西部出生的子宫内暴露于美沙酮（n=198）、丁丙诺啡（n=122）、纳曲酮（n=67）的新生儿以及未产前暴露于阿片类药物的新生儿（n=387）均纳入研究。然后，从出生到 5 岁生日期间，将儿童与州死亡、医院、急诊部（ED）、精神卫生、癌症和应报告疾病的记录进行链接。
与对照组相比，所有三种治疗方法的儿童住院率均升高，而仅美沙酮（p=0.002）和纳曲酮（p=0.044）暴露儿童的 ED 就诊率显著升高。就住院和 ED 就诊而言，暴露组与对照组儿童之间的差异在新生儿期最为明显。与对照组相比，丁丙诺啡暴露儿童的精神卫生门诊就诊率升高（p=0.005）。
本研究提供的证据表明，子宫内暴露于阿片类药物治疗的儿童与非暴露于阿片类药物的对照组儿童的健康状况存在差异。
子宫内暴露于阿片类药物治疗可能会影响儿童的健康，超出新生儿期的影响。
