Cognitive and behavioral impact on children exposed to opioids during pregnancy

Justine J. Larson, Devon L. Graham, Lynn T. Singer, Anna M. Beckwith, Mishka Terplan, Jonathan M. Davis, Juan Martinez, Henrietta S. Bada

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


The developmental impact of opioid use during pregnancy is a subject of ongoing debate. Short-term neonatal outcomes, such as lower birth weight and neonatal abstinence syndrome, are the most well-recognized outcomes. However, knowledge gaps exist regarding longer-term neurocognitive and mental health outcomes. In this article, we summarize an expert panel discussion that was held in April 2018 by the Substance Abuse and Mental Health Services Administration and attended by national experts in the field of perinatal opioid exposure and its impact on child development. Despite the challenges with research in this area, there is emerging literature revealing an association between neonates exposed to opioids in utero and longer-term adverse neurocognitive, behavioral, and developmental outcomes. Although adverse sequalae may not be apparent in the neonatal period, they may become more salient as children develop and reach preschool and school age. Multiple variables (genetic, environmental, and biological) result in a highly complex picture. The next steps and strategies to support families impacted by opioid use disorder are explored. Model programs are also considered, including integrated care for the child and mother, parenting supports, and augmentations to home visiting.

Original languageEnglish
Article numbere20190514
Issue number2
StatePublished - 2019

Bibliographical note

Funding Information:
FUNDING: Supported by the Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services.

Publisher Copyright:
Copyright © 2019 by the American Academy of Pediatrics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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