Madurai Nethra K, Jantzie Lauren L, Yen Elizabeth
Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Department of Neurodevelopmental Medicine, Phelps Center for Cerebral Palsy and Neurodevelopmental Medicine, Kennedy Krieger Institute, Baltimore, MD, United States.
Front Pediatr. 2024 Mar 21;12:1357970. doi: 10.3389/fped.2024.1357970. eCollection 2024.
The impact of the opioid epidemic on pregnant people and children is a growing public health crisis. Understanding how opioids affect the developing brain during pregnancy and postnatally remains a critical area of investigation. Biological sex plays a crucial role in all physiologic processes, with the potential for a significant impact on neonatal outcomes, including those infants with opioid exposure. Here, we aim to explore current literature on the effect of sex on neonatal outcomes following prenatal opioid exposure. Sex differences in adults with opioid use disorder have been well studied, including increased mortality among males and higher rates of psychiatric comorbidities and likelihood of relapse in females. However, such differences are not yet well understood in neonates. Emerging clinical data suggest sex-specific effects in infants with prenatal opioid exposure on the expression of genes related to feeding regulation and reward signaling pathways. Increased susceptibility to white matter injury has also been noted in female infants following prenatal opioid exposure. Understanding the impact of sex as a biological variable on neonatal outcomes following prenatal opioid exposure is paramount to improving the health and well-being of infants, children, and adults impacted by the opioid epidemic.
阿片类药物流行对孕妇和儿童的影响正成为日益严重的公共卫生危机。了解阿片类药物在孕期及产后如何影响发育中的大脑仍是一个关键的研究领域。生物性别在所有生理过程中都起着至关重要的作用，有可能对新生儿结局产生重大影响，包括那些暴露于阿片类药物的婴儿。在此，我们旨在探讨当前关于性别对产前暴露于阿片类药物后新生儿结局影响的文献。阿片类药物使用障碍成年患者的性别差异已得到充分研究，包括男性死亡率增加以及女性精神疾病合并症发生率更高和复发可能性更大。然而，此类差异在新生儿中尚未得到充分了解。新出现的临床数据表明，产前暴露于阿片类药物的婴儿在与喂养调节和奖赏信号通路相关的基因表达方面存在性别特异性影响。产前暴露于阿片类药物的女婴对白质损伤的易感性也有所增加。了解性别作为一个生物学变量对产前暴露于阿片类药物后新生儿结局的影响对于改善受阿片类药物流行影响的婴儿、儿童和成人的健康和福祉至关重要。
