Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway.
Department of Forensic Sciences, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Early Hum Dev. 2020 Apr;143:104997. doi: 10.1016/j.earlhumdev.2020.104997. Epub 2020 Mar 5.
To combine meta-analyses of multiple long-term outcomes in children prenatally exposed to methadone or buprenorphine through their mothers' Opioid maintenance therapy (OMT) with a systematic review of similar outcomes in experimental animals.
The Medline, Embase, Web of Science, CINAHL, Cochrane and Epistemonikos databases were searched through August 30, 2018. Clinical studies measuring effects on cognitive, behavioral or visual outcomes in 3 months or older children prenatally exposed to OMT and control group(s) were included for meta-analyses. Experimental animal studies with similar exposures and outcomes were included in a systematic review. The three authors independently performed abstract screenings and full-text reviews, and extracted the data. One author performed the meta-analyses.
The pooled results of the meta-analyses showed worse cognitive, psychomotor, behavioral, attentional and executive functioning, and affected vision in children born to mothers who were in OMT during pregnancy compared to children without prenatal drug exposure (overall effect size = 0.49, 95% confidence interval = 0.38, 0.59, p < 0.00001). Many of the experimental animal studies showed impaired outcomes after prenatal exposure to methadone or buprenorphine. The clinical results may be biased, e.g., with the OMT group having more concurrent risk factors than the unexposed comparison group. There are few studies of older children.
Children born to mothers in OMT show worse outcomes for a number of different behaviors and impaired vision compared to children born to nonusers. Experimental animal studies indicate that there might be a causal relationship between prenatal methadone or buprenorphine exposure and subsequent negative outcomes.
通过对母亲接受阿片类药物维持治疗（OMT）的儿童进行多项长期结局的荟萃分析，并结合实验动物类似结局的系统评价，来评估胎儿期暴露于美沙酮或丁丙诺啡的儿童的长期结局。
检索了 Medline、Embase、Web of Science、CINAHL、Cochrane 和 Epistemonikos 数据库，检索时间截至 2018 年 8 月 30 日。纳入了测量接受 OMT 的母亲所生的 3 个月或更大的儿童的认知、行为或视觉结局的影响，并与对照组进行比较的临床研究，以进行荟萃分析。纳入了具有类似暴露和结局的实验动物研究，以进行系统评价。三位作者独立进行了摘要筛选和全文审查，并提取了数据。一位作者进行了荟萃分析。
荟萃分析的汇总结果表明，与没有产前药物暴露的儿童相比，在妊娠期间接受 OMT 的母亲所生的儿童的认知、精神运动、行为、注意力和执行功能以及视力受到影响（总体效应量=0.49，95%置信区间=0.38，0.59，p<0.00001）。许多实验动物研究表明，胎儿期暴露于美沙酮或丁丙诺啡后，结果受损。临床结果可能存在偏倚，例如，OMT 组的同期危险因素比未暴露的对照组更多。很少有对年龄较大的儿童的研究。
与非使用者所生的儿童相比，接受 OMT 的母亲所生的儿童在许多不同行为和视力受损方面的结局更差。实验动物研究表明，胎儿期暴露于美沙酮或丁丙诺啡与随后的负面结果之间可能存在因果关系。
