Prenatally buprenorphine-exposed children: health to 3 years of age

• Published in: European journal of pediatrics 2015-11, Vol.174 (11), p.1525-1533
• Main Authors: Kivistö, Kaisa, Tupola, Sarimari, Kivitie-Kallio, Satu
• Format: Article
• Language: English
• Subjects: Age; Alcohol; Analgesics, Opioid - adverse effects; Buprenorphine - adverse effects; Child; Child abuse & neglect; Child Abuse - diagnosis; Child, Preschool; Children & youth; Congenital diseases; Diabetes; Drug abuse; Female; Finland - epidemiology; Health Status; Hepatitis B; Hepatitis C; Heroin; Hospitals; Humans; Immune system; Infant; Infant, Newborn; Infections; Male; Males; Medical records; Medicine; Medicine & Public Health; Methadone; Mothers; Narcotics; Neonatal abstinence syndrome; Original Article; Pediatrics; Pregnancy; Prenatal Exposure Delayed Effects - chemically induced; Prenatal Exposure Delayed Effects - epidemiology; Prospective Studies; SIDS; Substance abuse treatment; Sudden infant death syndrome; Urine; White people
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-015-2562-0

Our prospective study is among the first attempts to examine the health of prenatally buprenorphine-exposed children after neonatal age and to determine the types of child maltreatment in this patient group. The study population included 102 children (61/41 Caucasian males/females) who had a positive urine screen for buprenorphine as a newborn. In addition to buprenorphine, the children were also prenatally exposed to other substances. The data were collected by pediatricians in follow-up visits until 3 years of age and from medical records. Ten prenatally buprenorphine-exposed children (10 %) had some birth defect. The study children had slightly more major anomalies than newborns on average in Finland (3.4 %). Eye disorders (nystagmus, opticus atrophy, and strabismus) occurred in 11 % of children. One child was diagnosed with hepatitis C transmission. One female died of sudden infant death syndrome (SIDS), and one male died of congenital heart disease. Pediatricians submitted altogether 70 reports to child welfare services of suspected maltreatment. Of these reports, 45 (64 %) involved medical neglect. Physical abuse was suspected in four reports. Conclusion : We suggest that prenatally buprenorphine-exposed children have several types of problems with their health at toddler age and that they are susceptible to child maltreatment, especially to medical neglect. What is Known: • Buprenorphine is used in the treatment of opioid addiction in pregnancy. Prenatally buprenorphine-exposed newborns develop neonatal abstinence syndrome (NAS) in about 60 % of cases. Data on the health and maltreatment of these children after neonatal age are limited. What is New: • Prenatally buprenorphine-exposed children can have several types of problems with their physical health by 3 years of age, and they are susceptible to child maltreatment, especially to medical neglect.