Opioids play a crucial role in the development of the fetus, influencing various physiological processes. The introduction of external opioids during pregnancy has the potential to interfere with these intricate processes, impacting several bodily systems, with a notable emphasis on the immune system. This interaction gives rise to apprehensions regarding the potential lasting health effects on children who have been exposed to opioids before birth.
New research published in the journal JAMA Network Open reveals an association between prenatal exposure to prescription opioids and adverse health outcomes in children. The researchers compared the risk of hospitalization and emergency department presentation for immune-related conditions in children with and without prenatal opioid exposure. In the retrospective study, Kelty and colleagues utilized the health records of 401,462 children born in Western Australia between January 1, 2003, and December 31, 2018, and found that babies exposed to opioids in utero, including substances like oxycodone, methadone, and codeine, exhibited a higher likelihood of being diagnosed with infections, dermatitis, or eczema following birth.
The researchers also discovered a subsequent increased risk of asthma in these children during early childhood. However, the research did not find a significant association between prenatal opioid exposure and an elevated risk of allergies, anaphylaxis, or autoimmune conditions.
Kelty et al. emphasized that this research represents a significant step towards comprehending the complex association between prenatal exposures and the developing immune systems. Animal studies had previously suggested that opioids could alter the developing immune system, potentially compromising its ability to respond effectively to infections and other challenges. The study, however, fills a critical knowledge gap by demonstrating similar implications in humans and highlighting the role of the specific opioid and its intended use, such as pain treatment or addressing opioid use disorder.
The researchers also identified a significant factor in neonatal abstinence syndrome (NAS), a condition wherein infants experience withdrawal symptoms from opioids after birth. NAS presence was linked to an increased risk of certain health issues, including infection and skin conditions during the perinatal period. In particular, 14.1% of pregnancies involve prenatal opioid exposure, and 0.8% of neonates experience NAS. However, as children progressed beyond this early stage, NAS was not identified as the primary factor influencing immune-related conditions.
These findings underscore the need for further investigation into the immune changes induced by opioid exposure during pregnancy and the potential long-term health impacts on exposed children. The study raises important questions about the specific opioids and their indications, emphasizing the importance of understanding the timing and type of exposure in influencing a child’s health outcomes. Continued research in this area could contribute to improved prenatal care and interventions to reduce the potential risks associated with opioid exposure in utero.
Reference
Kelty E, Rae K, Jantzie LL, Wyrwoll CS, Preen DB. Prenatal Opioid Exposure and Immune-Related Conditions in Children. JAMA Network Open. 2024 Jan 17;7(1): e2351933.