Children had smaller brain volumes and cortical surface areas after prenatal opioid maintenance therapy exposure

Acta Paediatr. 2025 Feb;114(2):398-409. doi: 10.1111/apa.17448. Epub 2024 Oct 8.

Abstract

Aim: The studies have shown that infants with prenatal OMT exposure had smaller brain volumes than non-exposed controls, but long-term outcome data are lacking. We examined 5-13-year-old OMT-exposed children with brain MRI and tested motor and visual-motor functions and possible associations between brain morphology and outcome.

Methods: To this retrospective cohort study, we recruited 55 children with prenatal OMT exposure and 59 age- and gender-matched controls. They were examined with brain MRI, Movement-ABC and Beery-VMI. MRI images were processed with the Free Surfer® software to obtain volumetrics and estimates of cortical surface area and thickness. We used a general linear regression model (GLM) to calculate group differences.

Results: The children in the OMT group had smaller mean total intracranial volume (ICV), 1407 cm3 (CI 95% 1379-1434) versus 1450 cm3 (CI 95% 1423-1476) in the control group (p = 0.026). After adjusting for ICV, significant group differences persisted for volumes of amygdala, basal ganglia and mid-posterior part of corpus callosum. Cortical surface area was smaller in the left caudal middle frontal gyrus and the right inferior parietal lobule in the OMT-group. Visual-motor function was significantly correlated with ICV.

Conclusion: Prenatal OMT exposure may alter early brain development with possible negative long-term functional consequences.

MeSH terms

  • Adolescent
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Brain* / diagnostic imaging
  • Brain* / drug effects
  • Brain* / growth & development
  • Brain* / pathology
  • Case-Control Studies
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / drug effects
  • Cerebral Cortex / pathology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Organ Size
  • Pregnancy
  • Prenatal Exposure Delayed Effects*
  • Retrospective Studies

Substances

  • Analgesics, Opioid