Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239, United States.
Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Luisenstrasse 57, 10117 Berlin, Germany.
Neurotoxicol Teratol. 2021 Nov-Dec;88:107033. doi: 10.1016/j.ntt.2021.107033. Epub 2021 Sep 30.
Understanding of the effects of in utero opioid exposure on neurodevelopment is a priority given the recent dramatic increase in opioid use among pregnant individuals. However, opioid abuse does not occur in isolation-pregnant individuals abusing opioids often have a significant history of adverse experiences in childhood, among other co-occurring factors. Understanding the specific pathways in which these frequently co-occurring factors may interact and cumulatively influence offspring brain development in utero represents a priority for future research in this area. We highlight maternal history of childhood adversity (CA) as one such co-occurring factor that is more prevalent among individuals using opioids during pregnancy and which is increasingly shown to affect offspring neurodevelopment through mechanisms beginning in utero. Despite the high incidence of CA history in pregnant individuals using opioids, we understand very little about the effects of comorbid prenatal opioid exposure and maternal CA history on fetal brain development. Here, we first provide an overview of current knowledge regarding effects of opioid exposure and maternal CA on offspring neurodevelopment that may occur during gestation. We then outline potential mechanistic pathways through which these factors might have interactive and cumulative influences on offspring neurodevelopment as a foundation for future research in this area.
鉴于最近孕妇群体中阿片类药物使用的急剧增加，了解胎儿期暴露于阿片类药物对神经发育的影响是当务之急。然而，阿片类药物滥用并非孤立存在的——滥用阿片类药物的孕妇往往在童年时期有过严重的不良经历，以及其他同时存在的因素。了解这些经常同时发生的因素可能通过哪些特定途径相互作用，并在子宫内累积影响后代大脑发育，这是该领域未来研究的重点。我们强调母亲的童年逆境（CA）史是这样的一个共同发生的因素，在怀孕期间使用阿片类药物的个体中更为普遍，并且越来越多的证据表明，这种因素通过始于子宫内的机制影响后代的神经发育。尽管在使用阿片类药物的孕妇中，CA 史的发生率很高，但我们对合并产前阿片类药物暴露和母亲 CA 史对胎儿大脑发育的影响知之甚少。在这里，我们首先概述了目前关于阿片类药物暴露和母亲 CA 对后代神经发育的影响的知识，这些影响可能发生在妊娠期。然后，我们概述了这些因素可能通过哪些潜在的机制途径对后代的神经发育产生相互作用和累积影响，为该领域的未来研究奠定基础。
