MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK
Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK.
Arch Dis Child Fetal Neonatal Ed. 2022 Jan;107(1):98-104. doi: 10.1136/archdischild-2020-320102. Epub 2021 Feb 17.
Illicit use of opioids is a global health crisis with major implications for women and children. Strategies for managing opioid use disorder (OUD) in pregnancy have been tested over the past 40 years, but studies have focused on maternal and pregnancy outcomes, with less attention given to long-term follow-up of exposed children. Here, we provide a narrative review of recent advances in the assessment and management of neonatal opioid withdrawal syndrome (NOWS), and we summarise evidence from multiple domains-neuroimaging, electrophysiology, visual development and function, neurodevelopment, behaviour, cognition and education-which suggests that prenatal opioid exposure modifies child development. Further studies are required to determine the optimal management of pregnant women with OUD and babies with NOWS. We identify knowledge gaps and suggest that future study designs should evaluate childhood outcomes, including infant brain development and long-term neurocognitive and visual function.
阿片类药物的非法使用是一个全球性的健康危机，对妇女和儿童有重大影响。在过去的 40 年中，已经测试了管理妊娠期间阿片类药物使用障碍 (OUD) 的策略，但研究主要集中在母婴和妊娠结局上，对暴露于阿片类药物的儿童的长期随访关注较少。在这里，我们对新生儿阿片类戒断综合征 (NOWS) 的评估和管理的最新进展进行了叙述性综述，并总结了来自多个领域的证据——神经影像学、电生理学、视觉发育和功能、神经发育、行为、认知和教育——表明产前阿片类药物暴露会改变儿童的发育。需要进一步的研究来确定患有 OUD 的孕妇和患有 NOWS 的婴儿的最佳管理方法。我们确定了知识空白，并建议未来的研究设计应评估儿童的结局，包括婴儿的大脑发育以及长期的神经认知和视觉功能。
