Abstract
Background
The impact of prenatal opioid exposure on brain development remains poorly understood.
Methods
We conducted a prospective study of term-born infants with and without prenatal opioid exposure. Structural brain MRI was performed between 40 and 48 weeks postmenstrual age. T2-weighted images were processed using the Developing Human Connectome Project structural pipeline. We compared 63 relative regional brain volumes between groups.
Results
Twenty-nine infants with prenatal opioid exposure and 42 unexposed controls were included. The groups had similar demographics, except exposed infants had lower birth weights, more maternal smoking and maternal Hepatitis C, fewer mothers with a college degree, and were more likely non-Hispanic White. After controlling for sex, postmenstrual age at scan, birth weight, and maternal education, exposed infants had significantly smaller relative volumes of the deep gray matter, bilateral thalamic ventrolateral nuclei, bilateral insular white matter, bilateral subthalamic nuclei, brainstem, and cerebrospinal fluid. Exposed infants had larger relative volumes of the right cingulate gyrus white matter and left occipital lobe white matter.
Conclusions
Infants with prenatal opioid exposure had smaller brain volumes in multiple regions compared to controls, with two regions larger in the opioid-exposed group. Further research should focus on the relative contributions of maternal opioids and other exposures.
Impact
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Prenatal opioid exposure is associated with developmental and behavioral consequences, but the direct effects of opioids on the developing human brain are poorly understood.
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Prior small studies using MRI have shown smaller regional brain volumes in opioid-exposed infants and children.
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After controlling for covariates, infants with prenatal opioid exposure scanned at 40–48 weeks postmenstrual age had smaller brain volumes in multiple regions compared to controls, with two regions larger in the opioid-exposed group.
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This adds to the literature showing potential impact of prenatal opioid exposure on the developing brain.
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Change history
08 December 2020
A Correction to this paper has been published: https://doi.org/10.1038/s41390-020-01297-2
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Acknowledgements
This work was funded by KL2 TR001426 (to S.L.M.), R01 NS094200 (to N.A.P.), and R01 NS096037 (to N.A.P.).
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S.L.M. conceptualized and designed the study, drafted the initial manuscript, and revised the manuscript for important intellectual content. J.E.K. supervised data analysis, developed the figures, and revised the manuscript for important intellectual content. A.B. performed data analysis and revised the manuscript for important intellectual content. B.M.K.-F supervised data acquisition and revised the manuscript for important intellectual content. J.A.T. implemented the MRI protocol, supervised data acquisition, and revised the manuscript for important intellectual content. M.A. performed statistical analysis and revised the manuscript for important intellectual content. L.H. collected data and revised the manuscript for important intellectual content. N.A.P. supervised data collection and analysis, interpreted the data, and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
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Merhar, S.L., Kline, J.E., Braimah, A. et al. Prenatal opioid exposure is associated with smaller brain volumes in multiple regions. Pediatr Res 90, 397–402 (2021). https://doi.org/10.1038/s41390-020-01265-w
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DOI: https://doi.org/10.1038/s41390-020-01265-w
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