One-Year Neurodevelopmental Outcomes After Neonatal Opioid Withdrawal Syndrome: A Prospective Cohort Study.

• Type of Material: Article
• Authors: Kristen L Benninger, Nationwide Children's Hospital and The Ohio State University Wexner Medical Center, Columbus.; Celine Richard, The University of Tennessee Health Science Center College of Medicine, Memphis.; Sara Conroy, Nationwide Children's Hospital; Julia Newton, Center for Perinatal Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH.; Gerry H Taylor, Nationwide Children's Hospital and The Ohio State University Wexner Medical Center, Columbus.; Alaisha Sayed, Nationwide Children's Hospital and The Ohio State University Wexner Medical Center, Columbus.; Lindsay Pietruszewski, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH.; Mary Ann Nelin, Nationwide Children's Hospital and The Ohio State University Wexner Medical Center, Columbus.; Nancy Batterson, Nationwide Children's Hospital and The Ohio State University Wexner Medical Center, Columbus.; Nathalie Maitre, Emory University
• Language: English
• Date: 2022-08
• Publisher: American Speech-Language-Hearing Association
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 American Speech-Language-Hearing Association.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1044/2022_PERSP-21-00270
• Title of Journal or Parent Work: Perspect ASHA Spec Interest Groups
• Volume: 7
• Issue: 4
• Start Page: 1019
• End Page: 1032

Abstract

PURPOSE: The aims of this study were, in a cohort of children with neonatal opioid withdrawal syndrome (NOWS), (a) to report 1-year neurodevelopmental outcomes and specifically characterize speech, language, and hearing outcomes and (b) to report the prevalence of cleft lip and/or cleft palate. METHOD: This prospective observational cohort study includes newborns with confirmed in utero opioid exposure who received pharmacological treatment for NOWS. During 1-year-old developmental visits, we administered standardized assessments (Bayley Scales of Infant and Toddler Development-Third Edition [Bayley-III] or Developmental Assessment of Young Children-Second Edition [DAYC-2]-due to COVID-19 restrictions). We compared Bayley-III scores to standardized population means using one-sample z tests. We report estimates, 95% confidence intervals, and two-sided p values. RESULTS: We enrolled 202 infants (October 2018 to March 2020). Follow-up at 1-year was 80%. Infants with NOWS had lower Bayley-III scores at 1 year compared to published norms for cognitive, language, and motor domains. One infant with NOWS was diagnosed with isolated cleft palate and Pierre Robin sequence. All infants passed the newborn hearing screen, and 7.5% had a formal hearing evaluation after neonatal intensive care unit discharge, with 40% having abnormal or inconclusive results; middle ear effusion was the leading cause of abnormal hearing (66.7%). Ten percent of children received a speech-language pathology referral prior to 2 years of age. Infants born to mothers with mental health conditions were more likely to have Bayley-III or DAYC-2 scores below 95 in language or motor domains. CONCLUSIONS: Infants with pharmacologically treated NOWS have significantly lower cognitive, language, and motor scores on standardized developmental testing compared to population means at 1 year of age. Early speech-language pathology referral is frequently necessary to promote optimal development in this population. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20044403.