Effects of opioid use in pregnancy on pediatric development and behaviour in children older than age 2: Systematic review.

OBJECTIVE: To summarize information on the effects of opioid use in pregnancy on subsequent pediatric development and behaviour. DATA SOURCES: Searches were performed in EMBASE, MEDLINE, and PsycINFO for peer-reviewed, English articles, including a manual search of their references, that were published between January 1, 2000, and May 1, 2018. STUDY SELECTION: Of the 543 articles reviewed, 19 relevant articles that focused on developmental effects of opioid exposure in utero were identified. Most of the studies provided level II evidence. One level I meta-analysis and 1 level III expert committee report were included. SYNTHESIS: The literature was divided between documenting some level of impairment or normalization of early development deficits over time. Often no opioid effect was found once researchers controlled for socioenvironmental factors. The degree to which environmental factors, opioid exposure, or both affect pediatric development remains to be determined.
CONCLUSION: The effect of maternal opioid use on pediatric development is unclear and the evidence is inconsistent. However, opioid exposure in pregnancy does define these children as a population at risk. They might experience developmental delays compared with their peers, yet remain within population norms in cognition, fine-motor skills, hand-eye coordination, executive function, and attention and impulsivity levels. Copyright© the College of Family Physicians of Canada.