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

### 研究目的
本研究针对新生儿阿片类药物戒断综合征（Neonatal Opioid Withdrawal Syndrome, NOWS）患儿队列，旨在达成两项研究目标：(a) 报告其1年神经发育结局，重点表征言语、语言及听力结局；(b) 统计唇裂和/或腭裂的患病率。

### 研究方法
本前瞻性观察队列研究纳入经确诊的宫内阿片类药物暴露且接受新生儿阿片类药物戒断综合征药物治疗的新生儿。在1岁发育随访阶段，我们采用标准化评估工具（受新冠疫情防控限制，选用贝利婴幼儿发育量表第三版（Bayley Scales of Infant and Toddler Development–Third Edition, Bayley-III）或幼儿发育评估量表第二版（Developmental Assessment of Young Children–Second Edition, DAYC-2））开展评估。我们通过单样本z检验将贝利-III量表得分与标准化人群常模进行对比，并报告了效应估计值、95%置信区间及双侧p值。

### 研究结果
本研究共纳入202名婴儿（入组时间为2018年10月至2020年3月），1年随访率为80%。与已发表的人群常模相比，新生儿阿片类药物戒断综合征患儿在1岁时的贝利-III量表认知、语言及运动维度得分均更低。1名患儿被诊断为单纯性腭裂合并皮埃尔·罗宾序列征。所有婴儿均通过了新生儿听力筛查，但在新生儿重症监护病房出院后，7.5%的婴儿接受了正式听力评估，其中40%的评估结果为异常或不确定；中耳积液是导致听力异常的主要诱因（占比66.7%）。10%的儿童在2岁前接受了言语语言病理学转诊。合并精神疾病的母亲所生婴儿，其语言或运动维度的贝利-III或DAYC-2量表得分更有可能低于95分。

### 研究结论
与人群常模相比，接受药物治疗的新生儿阿片类药物戒断综合征患儿在1岁时的标准化发育评估得分在认知、语言及运动维度均显著更低。该人群常需早期言语语言病理学转诊，以促进其最佳发育。

### 补充材料S1
新生儿阿片类药物戒断综合征患儿的1年神经发育结局。
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患儿的1年神经发育结局：一项前瞻性队列研究. 《美国言语语言听力协会专业兴趣小组视角》, 提前在线发表. https://doi.org/10.1044/2022_PERSP-21-00270