Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Pharmacoepidemiol Drug Saf. 2020 Jun;29(6):736-744. doi: 10.1002/pds.5009. Epub 2020 May 8.
An increasing consumption of opioids has been reported. The primary aim of the present study was follow-up of neurocognitive development in children exposed to analgesic opioids during pregnancy, using three different validated instruments to assess language and communication development at 5 years.
The Norwegian Mother and Child Cohort Study (MoBa) prospectively included pregnant women 1999 to 2008. Participants reported medication use at pregnancy week 17/18 and 30, and 6 months after birth. Children's language competence and communication skills at 5 years were reported by mothers on three different validated scales; The Ages and Stages Questionnaire (ASQ), The Speech and Language Assessment Scale (SLAS) and The Twenty Statements about Language-Related Difficulties list (Language20Q).
A total of 27 428 women with 33 407 singleton pregnancies were included. Use of analgesic opioids was reported in 584 pregnancies (1.7%). No associations between opioid use and lower language competence or communication skills were found. For ASQ, the OR of being in the lowest category vs the group with maximum mean score was 0.82 (95%CI 0.57, 1.17), for SLAS the OR of scoring worse than typical for age vs better than typical for age was 0.84 (0.61, 1.17) in children exposed to opioids in utero. For Language20Q using the best performance category as reference, the OR of scoring in the lower performance category was 0.57 (0.35, 0.91) with exposure to opioids.
Use of analgesic opioids in pregnant women does not seem to negatively affect language development or communication skills in children at 5 years.
有报道称阿片类药物的消耗量不断增加。本研究的主要目的是使用三种不同的经过验证的工具来评估语言和交流发展，对在妊娠期间接受镇痛阿片类药物的儿童进行神经认知发展的随访，以评估 5 岁时的语言和交流发展。
挪威母亲和儿童队列研究（MoBa）前瞻性地纳入了 1999 年至 2008 年的孕妇。参与者在妊娠第 17/18 周和第 30 周以及产后 6 个月报告了药物使用情况。儿童在 5 岁时的语言能力和沟通技能由母亲在三个不同的经过验证的量表上报告；年龄和阶段问卷（ASQ）、言语和语言评估量表（SLAS）和语言相关困难的 20 个陈述列表（Language20Q）。
共有 27428 名女性和 33407 名单胎妊娠被纳入研究。在 584 例妊娠中报告了使用镇痛阿片类药物（1.7%）。未发现阿片类药物使用与语言能力或沟通技能较低之间存在关联。对于 ASQ，与最高平均得分组相比，处于最低得分组的 OR 为 0.82（95%CI 0.57，1.17），对于 SLAS，与年龄典型相比得分较差的 OR 为 0.84（0.61，1.17），在胎儿中暴露于阿片类药物的儿童中。对于 Language20Q，以最佳表现类别作为参考，暴露于阿片类药物的儿童的得分较低表现类别的 OR 为 0.57（0.35，0.91）。
孕妇使用阿片类镇痛药似乎不会对 5 岁儿童的语言发展或沟通技能产生负面影响。
