A new study from Cincinnati Children’s Hospital Medical Center shows that newborns who require treatment for opioid withdrawal are at higher risk than others for delayed language, cognitive and motor skills.
Cincinnati Children’s this week released the study of 87 children who have been treated at its long-term Neonatal Abstinence Syndrome Clinic.
The study looked at neurodevelopment of 2-year-olds who’d been treated for the syndrome that can occur in newborns who were exposed to opioids in utero. Some of the mothers had taken heroin while pregnant; others were prescribed opioid medication for the addiction.
“These children are at risk for developmental delay,” said Dr. Stephanie Merhar, a neonatologist at Cincinnati Children’s and the lead author of the neurodevelopmental study.
They also have higher rates of what’s called strabismus, commonly known as crossed eyes, than the general population.
Some NAS toddlers – including Ava, 2, of Reading – experience one significant delay but none of the others. Hers is language development.
Ava loves to spin around, climb, feed her family’s fish, and listen and dance to toddler-rated YouTube songs. But she will often point and scream when she wants something because she does not speak words.
Ava was treated for opioid withdrawal when she was born July 22, 2016, at St. Elizabeth Edgewood Hospital. Her adoptive mother, Meichelle Hunley of Reading, has had Ava since she was two days old.
“She’s about a year and a half behind in her speech,” Hunley said.
The communication barrier has been frustrating for Ava, who seems to understand everything, her mom said.
Ava was not among the 2-year-olds who were part of the Children’s Hospital study, but she received the same assessment as those toddlers did: the Bayley Scales of Infant and Toddler Development.
Merhar said the recent study found that the test scores of toddlers were “significantly” lower than national averages. But she noted that it’s not clear whether the children’s intelligence or academic performance will be affected later on, in school.
The toddlers generally fell within the lower part of the “normal” range in their scores.
“These are not the kids who are so obviously developmentally delayed,” Merhar said. “You might not know it.”
The study showed that 2-year-olds who had been living with foster or adoptive families were more likely to have higher cognitive scores. The result indicates to researchers that there might be a socioeconomic factor involved in the children’s development, Merhar said.
The study doesn’t suggest the infants should be removed from their biological families, she said, but instead that their families should be provided supports to raise them.
Merhar said the study shows that babies who were exposed in utero to opioids should be monitored closely and provided with medical intervention as needed as they grow.
“We encourage close medical follow up and screening early-on for delays,” she said.
That’s just what has happened with Ava. She goes to Cincinnati Children’s Mason clinic for speech therapy. She is learning sign language and has begun using cards to identify objects.
Ava also has home visits from an Ohio Health Department program called Help Me Grow. She’ll be enrolled in preschool in Reading Community Schools this fall, at 3 years old, to give her a jump on learning, Hunley said.
Merhar said few neurodevelopmental studies have been undertaken in the United States on toddlers who were treated for Neonatal Abstinence Syndrome from opioids.
Dr. Jennifer McAllister, a co-director of Children’s NAS follow-up clinic, said she’s aware of one larger study than the Children’s Hospital study, and it focused on school-aged children.
The Cincinnati Children’s study on Neonatal Abstinence Syndrome is published online in the Journal of Perinatology.