AIM To examine the developmental outcomes of children born to opioid-dependent females enrolled in methadone maintenance and identify pre- and postnatal factors that place these children at developmental risk. METHOD Ninety-nine methadone-maintained females and their 100 infants (42 females, 58 males, mean gestational age 38.8wks) were recruited during pregnancy/at birth and studied to age 2 years alongside a regionally representative comparison group of 108 non-methadone-maintained females and their 110 infants (62 females, 48 males, mean gestational age 39.2wks). Information about perinatal exposure was collected from medical records, maternal urine and infant meconium toxicological analysis, maternal interviews (at birth and at 18mo), and a home visit (at 18mo). At age 2 years, child neuromotor function, cognition, language, and emotional/behavioral dysregulation were assessed. RESULTS Opioid-exposed children achieved lower motor, cognitive, and language scores and had poorer self, emotional, eating/feeding, and sensory processing regulation than unexposed children. After adjustment for maternal education and other substance use in pregnancy, between-group differences in child motor, cognitive, and overall dysregulation remained. Postnatal parental and family factors explained a further 40% to 52% of between-group differences in child outcomes. INTERPRETATION These children and families are extremely high-risk and need antenatal and postnatal support. Children exposed to opioids during pregnancy have pervasive developmental difficulties by age 2 years. These challenges are largely explained by adverse pregnancy and socio-environmental exposures, emphasizing the importance of specialist prenatal care and postnatal intervention support.

中文翻译：

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2岁儿童产前美沙酮暴露与儿童发育结局

目的 检查参加美沙酮维持治疗的阿片类药物依赖女性所生儿童的发育结果，并确定使这些儿童面临发育风险的产前和产后因素。方法 在怀孕期间/出生时招募了 99 名美沙酮维持女性及其 100 名婴儿（42 名女性，58 名男性，平均胎龄 38.8 周），并与区域代表性的 108 名非美沙酮对照组一起研究至 2 岁。维持女性及其 110 名婴儿（女性 62 名，男性 48 名，平均胎龄 39.2 周）。有关围产期暴露的信息来自医疗记录、母亲尿液和婴儿胎粪毒理学分析、母亲访谈（出生时和 18 个月时）和家访（18 个月时）。2 岁时，儿童的神经运动功能、认知、语言、和情绪/行为失调进行了评估。结果 与未接触阿片类药物的儿童相比，接触阿片类药物的儿童的运动、认知和语言分数较低，自我、情绪、进食/喂养和感觉处理调节能力较差。在调整孕期母亲教育和其他物质使用后，儿童运动、认知和整体失调的组间差异仍然存在。产后父母和家庭因素进一步解释了儿童结局组间差异的 40% 至 52%。解释 这些儿童和家庭的风险极高，需要产前和产后支持。怀孕期间接触阿片类药物的儿童在 2 岁时普遍存在发育困难。这些挑战主要是由不良妊娠和社会环境暴露来解释的，