McNelis Kera, Gerdts Grace, Khan Maya, McAllister Jennifer
Children's Healthcare of Atlanta, Atlanta, GA, USA.
Emory University, Atlanta, GA, USA.
Pediatr Res. 2025 Mar 27. doi: 10.1038/s41390-025-04006-z.
Newborns with Neonatal Opioid Withdrawal Syndrome (NOWS) are at risk for smaller size at birth, including weight, length, and head circumference. We hypothesized that children with a history of prenatal opioid exposure and NOWS would have smaller size as infants and toddlers.
This retrospective cohort study analyzed a cohort developed from the electronic medical records of all patients who were seen in the NOWS Clinic at a free-standing children's hospital system through age two years. Anthropometric measurements, demographics, substance and pharmacologic exposures, custodian status and nutritional data were extracted.
The final sample size included 1190 subjects with 7700 patient encounters. 1153 (97%) had four or more visits in the first two years of life. Forty-four percent of height measurements were below the tenth percentile. Prenatal methadone exposure was negatively associated with later growth. Infants with lower weight, height, and head circumference were prescribed higher caloric density infant formula. Forty percent of the weight measurements were less than the tenth percentile before 6 months, and this improved to 9.3% at 18-25-month visits.
Children with a history of prenatal opioid exposure are at risk for later short stature. Prenatal methadone exposure specifically is associated with decreased height.
This large retrospective cohort study found that toddlers with a history of prenatal opioid exposure and Neonatal Opioid Withdrawal Syndrome are at risk for short stature. Prenatal methadone, but not buprenorphine, exposure is negatively associated with later growth in children with a history of prenatal opioid exposure. The proportion of weight under the tenth percentile improved from infant to toddler ages in children with a history of prenatal opioid exposure.
患有新生儿阿片类药物戒断综合征（NOWS）的新生儿出生时体型较小，包括体重、身长和头围。我们假设，有产前阿片类药物暴露史且患有NOWS的儿童在婴幼儿期体型会较小。
这项回顾性队列研究分析了一个队列，该队列来自一家独立儿童医院系统的NOWS诊所中所有就诊至两岁的患者的电子病历。提取了人体测量数据、人口统计学数据、物质和药物暴露情况、监护人状况以及营养数据。
最终样本量包括1190名受试者，共7700次患者就诊记录。1153名（97%）在生命的前两年有四次或更多次就诊。44%的身高测量值低于第十百分位数。产前美沙酮暴露与后期生长呈负相关。体重、身高和头围较低的婴儿被开具了高热量密度的婴儿配方奶粉。6个月前，40%的体重测量值低于第十百分位数，在就诊18至25个月时，这一比例降至9.3%。
有产前阿片类药物暴露史的儿童后期有身材矮小的风险。尤其是产前美沙酮暴露与身高降低有关。
这项大型回顾性队列研究发现，有产前阿片类药物暴露史且患有新生儿阿片类药物戒断综合征的幼儿有身材矮小的风险。产前美沙酮暴露而非丁丙诺啡暴露与有产前阿片类药物暴露史儿童的后期生长呈负相关。有产前阿片类药物暴露史的儿童体重低于第十百分位数的比例从婴儿期到幼儿期有所改善。
