One-year neurodevelopmental outcomes after neonatal opioid withdrawal syndrome (Benninger et al., 2022)

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 S1. 1-year neurodevelopmental outcomes after neonatal opioid withdrawal syndrome.

Benninger, K. L., Richard, C., Conroy, S., Newton, J., Taylor, H. G., Sayed, A., Pietruszewski, L., Nelin, M. A., Batterson, N., & Maitre, N. L. (2022). One-year neurodevelopmental outcomes after neonatal opioid withdrawal syndrome: A prospective cohort study. Perspectives of the ASHA Special Interest Groups. Advance online publication. https://doi.org/10.1044/2022_PERSP-21-00270

本研究旨在新生儿阿片类药物戒断综合征（NOWS）的队列中，（一）报告1年的神经发育结果，并特别描述语言、交流和听力结果；（二）报告兔唇和/或裂腭的患病率。
方法：这是一项前瞻性观察性队列研究，包括确认在子宫内暴露于阿片类药物并接受NOWS药物治疗的新生儿。在1岁发育访问期间，我们进行了标准化评估（Bayley婴儿和幼儿发育量表第三版[Bayley-III]或儿童发育评估第二版[DAYC-2]——由于COVID-19限制）。我们使用单样本z检验将Bayley-III评分与标准化人群平均值进行比较。我们报告估计值、95%置信区间和双尾p值。
结果：我们招募了202名婴儿（2018年10月到2020年3月）。1年的随访率为80%。与已发表的认知、语言和运动领域的正常值相比，NOWS婴儿在1岁时Bayley-III评分较低。一名NOWS婴儿被诊断为孤立性裂腭和Pierre Robin序列。所有婴儿均通过了新生儿听力筛查，7.5%的婴儿在新生儿重症监护室出院后接受了正式的听力评估，其中40%的结果异常或不明确；中耳积液是异常听力的主要原因（66.7%）。10%的儿童在2岁之前接受了言语病理学的转诊。母亲有心理健康状况的婴儿更有可能在其语言或运动领域拥有低于95分的Bayley-III或DAYC-2评分。
结论：与1岁时的群体平均水平相比，接受药物治疗的NOWS婴儿在标准化发育测试中的认知、语言和运动评分显著较低。早期言语病理学转诊对于促进该人群的优化发展通常是必要的。
补充材料S1：新生儿阿片类药物戒断综合征后的1年神经发育结果。
Benninger, K. L., Richard, C., Conroy, S., Newton, J., Taylor, H. G., Sayed, A., Pietruszewski, L., Nelin, M. A., Batterson, N., & Maitre, N. L. (2022). 新生儿阿片类药物戒断综合征后的1年神经发育结果：一项前瞻性队列研究。ASHA特殊兴趣小组的视角。在线预发表。https://doi.org/10.1044/2022_PERSP-21-00270