Prenatal opioid exposure may have lasting effects on children's health, with a notable increase in the risk of eczema and dermatitis during the perinatal period, as indicated by a study conducted in Australia.
The timing of this study coincides with a significant rise in opioid use among pregnant women. According to an estimate reported in JAMA in 2022, the number of women diagnosed with opioid-related issues during delivery surged by 131% from 2010 to 2017. The US Centers for Disease Control and Prevention (CDC) revealed that, based on self-reported data from 2019, approximately 7% of women admitted to using prescription opioid pain relievers during pregnancy, with 1 in 5 acknowledging misuse.
Researchers from the University of Western Australia undertook a cohort study involving 401,462 newborns born between January 1, 2003, and December 31, 2018, to explore the potential effects of maternal opioid use on neonates and children. Unlike previous studies primarily focusing on infections, this research aimed to investigate various immune system-related conditions.
The study aimed to determine the occurrences of three types of immune system-related conditions:
Infective Diseases: Such as sepsis, conjunctivitis, urinary tract infections, and candidiasis.
Conditions linked to an Overactive Immune System and Inflammation: Including asthma, eczema, allergies, and anaphylaxis.
Autoimmune Diseases: Such as rheumatoid conditions, inflammatory bowel disease, and type 1 diabetes.
Using data from hospital, emergency department, and mortality records, the researchers identified instances where children under 5 years were diagnosed with these conditions.
The findings revealed that perinatal opioid exposure was associated with an increased risk of perinatal infections, with a particularly high odds ratio. Additionally, there was a significant increase in the risks of eczema and dermatitis compared to nonexposure.
Perinatal eczema and dermatitis were mainly diaper dermatitis and erythema intertrigo. The study authors pointed out that neonatal abstinence syndrome, indicating withdrawal, played a significant role in perinatal eczema and dermatitis among neonates with prenatal opioid exposure.
Prenatal opioid exposure was also linked to a higher risk of childhood asthma but not allergies and anaphylaxis.
Infants with prenatal opioid exposure were more likely to be born prematurely, have low birth weight for gestational age, and be exposed to cigarette smoke compared to nonexposed infants.
The researchers emphasized that the potential effects of prenatal opioid exposure might depend on the timing of exposure, corresponding with critical windows of vulnerability in the development of the immune system, the presence or absence of neonatal opioid withdrawal syndrome, and the type of opioid exposure.
In this study, 70.8% of children with prenatal opioid exposure were exposed during the first trimester, 73.7% during the second trimester, and 76.4% during the third trimester. Additionally, 41% were exposed to opioids for pain treatment, while 60.8% were exposed to opioids for opioid use disorder treatment.
In conclusion, this research sheds light on the potential risks associated with prenatal opioid exposure, emphasizing the importance of understanding the complexities involved in the immune system development during pregnancy.