Data_Sheet_1_Prenatal Exposures Are Associated With Worse Neurodevelopmental Outcomes in Infants With Neonatal Opioid Withdrawal Syndrome.docx

Aim: To define a developmental trajectory in infants with neonatal opioid withdrawal syndrome (NOWS) and determine whether the impacted developmental domain varies with the type of antenatal exposure.
Methods: We performed a retrospective cohort study of infants treated pharmacologically for NOWS and assessed using a standardized schedule for follow-up visits. We compared outcomes of the study population to published norms using one-sample t-tests. Multivariable models examined associations with exposures in addition to opioids.
Results: In our cohort of 285 infants with 9–12-months testing, 164 (55.7%) were seen at 3–4 months, and 125 (44%), at 15–18 months. The majority (58%) had intrauterine drug exposures in addition to opioids. Neurodevelopmental scores of infants with NOWS at 3–4 and 9–12 months were not different from published norms. Cognitive and language scores at 15–18 months were worse than published norms. Male sex, older maternal age, and additional barbiturate or alcohol exposure were associated with worse outcomes.
Conclusion: Infants with pharmacologically treated NOWS had development similar to unexposed infants during the 1st year but worse cognitive and language scores during the 2nd year. These data support the need for a prospective follow-up of large cohorts of infants with NOWS, with systematic assessments and an evaluation of contributing factors.

研究目的：明确新生儿阿片类药物戒断综合征（Neonatal Opioid Withdrawal Syndrome, NOWS）患儿的发育轨迹，并探究受影响的发育领域是否随产前暴露类型的不同而存在差异。
研究方法：本研究针对接受药物治疗的新生儿阿片类药物戒断综合征患儿开展回顾性队列研究，采用标准化随访流程对患儿进行评估。通过单样本t检验，将研究人群的结局指标与已发表的正常参照标准进行对比；同时构建多变量模型，分析除阿片类药物外其他暴露因素与结局的关联。
研究结果：本队列共纳入285名婴儿，其中完成9~12月龄检测随访者共285例，3~4月龄随访者164例（占比55.7%），15~18月龄随访者125例（占比44%）。多数患儿（58%）除阿片类药物暴露外，还存在宫内其他药物暴露。在3~4月龄及9~12月龄时，新生儿阿片类药物戒断综合征患儿的神经发育评分与已发表的正常参照标准无显著差异；而在15~18月龄时，其认知及语言评分均低于正常参照标准。男性性别、产妇年龄偏大以及合并巴比妥类或酒精暴露均与不良结局相关。
研究结论：接受药物治疗的新生儿阿片类药物戒断综合征患儿在出生后第一年的发育水平与未暴露婴儿相似，但在第二年的认知及语言评分更差。本研究数据提示，需对新生儿阿片类药物戒断综合征患儿开展大型队列的前瞻性随访研究，并进行系统化评估及相关影响因素分析。