Spowart Katherine M, Reilly Kasey, Mactier Helen, Hamilton Ruth
Specialist Children's Services, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom.
Princess Royal Maternity, NHS Greater Glasgow and Clyde, Glasgow, United Kingdom.
Front Pediatr. 2023 Apr 18;11:1118634. doi: 10.3389/fped.2023.1118634. eCollection 2023.
The aim of this study was to examine executive function and emotional and behavioural difficulties of children aged between 8 and 10 years who had been prenatally exposed to methadone, compared to non-exposed peers.
Prospective study: third follow-up of an original cohort of 153 children born to methadone-maintained opioid-dependent mothers 2008-2010: previous investigations were at 1-3 days and at 6-7 months of age. Carers completed the Strength and Difficulties Questionnaire (SDQ) and the Behaviour Rating Inventory of Executive Function, Second Edition (BRIEF®2). Results were compared between exposed and non-exposed groups.
Carers of 33 of 144 traceable children completed the measures. SDQ responses showed no group differences on subscales of emotional symptoms, conduct problems, or peer relationship problems. A marginally higher proportion of exposed children had a high or very high hyperactivity subscale score. Exposed children scored significantly higher on BRIEF®2 behavioural, emotional, and cognitive regulation indices, and on the global executive composite. After controlling for potentially confounding higher reported maternal tobacco use in the exposed group regression modelling, the effect of methadone exposure reduced.
This study supports evidence that methadone exposure is associated with adverse neurodevelopmental outcomes in childhood. Challenges in studying this population include difficulties with long-term follow-up and controlling for potentially confounding factors. Further investigation of the safety of methadone and other opioids in pregnancy must include consideration of maternal tobacco use.
本研究旨在调查8至10岁在产前接触过美沙酮的儿童与未接触过美沙酮的同龄儿童相比的执行功能以及情绪和行为问题。
前瞻性研究：对2008年至2010年由美沙酮维持治疗的阿片类药物依赖母亲所生的153名儿童的原始队列进行第三次随访；之前的调查是在1至3天和6至7个月大时进行。照料者完成了优势与困难问卷（SDQ）和执行功能行为评定量表第二版（BRIEF®2）。对接触组和未接触组的结果进行比较。
在144名可追踪儿童中，33名儿童的照料者完成了测量。SDQ的回答显示，在情绪症状、行为问题或同伴关系问题的分量表上两组没有差异。接触美沙酮的儿童中多动分量表得分高或非常高的比例略高。接触美沙酮的儿童在BRIEF®2行为、情绪和认知调节指数以及总体执行功能综合评分上得分显著更高。在对接触组中报告的母亲吸烟率较高这一潜在混杂因素进行控制后（回归模型），美沙酮接触的影响有所降低。
本研究支持了美沙酮接触与儿童期不良神经发育结局相关的证据。研究这一人群的挑战包括长期随访困难以及控制潜在的混杂因素。对孕期美沙酮和其他阿片类药物安全性的进一步调查必须考虑母亲吸烟情况。
