The opioid epidemic in the United States has resulted in a significant increase in opioid use disorder among pregnant women and a concomitant increase in the incidence of neonatal opioid withdrawal syndrome. The long-term consequences of prenatal opioid exposure on neurodevelopmental outcomes are not fully understood. Animal studies indicate increased neuronal apoptosis and decreased neuronal proliferation and myelination with opioid exposure in-utero. Meta-analyses of human studies suggest decreased cognition and psychomotor performance in infancy and deficits in cognition and language in preschool. However, current studies have primarily focused on heroin or methadone exposure and have been limited by small sample size, inadequate comparison groups, and the inability to account for additional risk factors and exposures such as polysubstance abuse, poor prenatal care, neonatal withdrawal and treatment with opioids, and unsupportive home environment. Future studies should aim to better understand the potential impact of these confounding factors on the neurodevelopmental trajectory of exposed infants. This review discusses the up-to-date literature, current gaps in knowledge, and considerations for future studies in the arena of prenatal opioid exposure and neurodevelopmental outcomes.

中文翻译：

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产前阿片类药物暴露和神经发育结果。

美国的阿片类药物流行导致孕妇阿片类药物使用障碍显着增加，新生儿阿片类药物戒断综合征的发病率也随之增加。产前阿片类药物暴露对神经发育结果的长期影响尚不完全清楚。动物研究表明，在子宫内接触阿片类药物会增加神经元凋亡，减少神经元增殖和髓鞘形成。人类研究的荟萃分析表明，婴儿期认知和心理运动表现下降，学龄前儿童认知和语言缺陷。然而，目前的研究主要集中在海洛因或美沙酮暴露上，并受到样本量小、对照组不足、无法考虑其他风险因素和暴露，例如多种物质滥用、产前护理不佳、新生儿戒断和阿片类药物治疗以及不支持的家庭环境。未来的研究应该旨在更好地了解这些混杂因素对暴露婴儿神经发育轨迹的潜在影响。这篇综述讨论了最新的文献、当前的知识差距以及对产前阿片类药物暴露和神经发育结果领域未来研究的考虑。