Health of prenatally buprenorphine-exposed children to three years of age

Kaisa Kivistö

Research output: ThesisDoctoral Thesis

Abstract

Illicit use of prescription opioids has increased markedly in recent years, especially in Europe and North America. In Finland, the number of opioid problem users constantly increased through the 2000s, levelling off in 2012. Buprenorphine is a semisynthetic opioid that was originally administered as an analgesic, but later also used in opioid detoxification and maintenance treatment. However, buprenorphine abuse has been reported in many countries. In Finland, buprenorphine is the most common injection drug. Buprenorphine use in late pregnancy leads to neonatal abstinence syndrome (NAS) in roughly 60% of newborns. Data on buprenorphine-exposed children´s health after the neonatal period is scarce. Our aim was to identify the health problems of these children from infancy to three years of age. The study population comprised altogether 108 children with a positive drug screen for buprenorphine as a newborn. Children were born in 2000s in Helsinki University Central Hospital (HUCH). One main finding was that pediatricians observed multiple types of child abuse and neglect in the study population in HUCH. Pediatricians made altogether 70 child welfare reports. Repeated failure to come to an appointment, which was considered medical neglect, constituted 64% of the child welfare reports. In four children, physical abuse was suspected. Another main finding was that buprenorphine-exposed children had significantly more early childhood caries than control children. The study raised concern for dental neglect in buprenorphine-exposed children. We also discovered that 10% of buprenorphine-exposed children had been diagnosed with strabismus and 5% had a major congenital anomaly. Of 102 children, four had an umbilical or inguinal hernia and three had infantile pyloric stenosis. The psychological study revealed poorer cognitive abilities in buprenorphine-exposed children at three years old than in controls as well as reduced performance of mother-child dyads in terms of emotional availability and perceived maternal self-efficacy. In the MEG study, somatosensory and auditory evoked potentials did not show significant differences between the buprenorphine-exposed group and the control group. Prenatally buprenorphine-exposed children exhibit more early childhood caries and dental neglect than control children. In addition to dental neglect, the children are exposed to multiple types of child maltreatment as well as to unfavorable emotional features in the caregiver-child relationship. Based on health and maltreatment issues revealed here, a pediatric follow-up with a multi-professional team, including a dentist, is essential.
Original languageEnglish
Place of PublicationHelsinki
Publisher
Print ISBNs978-951-51-1814-1
Publication statusPublished - 2015
MoE publication typeG5 Doctoral dissertation (article)

Bibliographical note

M1 - 111 s. + liitteet
Helsingin yliopisto

Fields of Science

  • Brain
  • +drug effects
  • Buprenorphine
  • +adverse effects
  • Child Abuse
  • Child Development
  • Child, Preschool
  • Congenital Abnormalities
  • +epidemiology
  • Evoked Potentials
  • Infant
  • Infant, Newborn
  • Neonatal Abstinence Syndrome
  • Oral Health
  • Prenatal Exposure Delayed Effects
  • Substance-Related Disorders
  • +complications
  • 3123 Gynaecology and paediatrics

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