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Meta-Analysis
. 2023 Mar;43(3):259-270.
doi: 10.1038/s41372-022-01466-7. Epub 2022 Jul 29.

Impact of prenatal opioids on cardiac and autonomic development: systematic review and meta-analysis

Meghan P Howell  1 , Carlie A Wiseman  2 , Maya Z Rosen  3 , Winifred M Yeates  4 , Laura A Wright  5 , Samantha S O'Connell  6 , Benjamin Bhunu  7 , Suttira Intapad  7 , Thomas R Kimball  8   9 , Stefanie Cheang  8 , Kelly K Gajewski  8   9
Affiliations
Meta-Analysis

Impact of prenatal opioids on cardiac and autonomic development: systematic review and meta-analysis

Meghan P Howell et al. J Perinatol. 2023 Mar.

Abstract

Prenatal opioid exposure has recently risen four-fold with limited data on the developmental effects on neonatal physiology. The objective of this systematic review is to develop an association between prenatal opioid exposure and fetal and neonatal cardiac and autonomic development and function. The review was conducted in accordance with PRISMA Guidelines, and searches were conducted using PubMed, Embase, CINAHL, and Web of Science between May 25 and October 27, 2020. Twenty studies fit inclusion criteria, in four categories: (1) fetal cardiac outcomes, (2) neonatal cardiac outcomes, (3) noninvasive autonomic outcomes, and (4) clinical and behavioral measures. For the meta-analysis, three studies (total of 210 subjects) were included. Effect sizes were measured as the mean difference in fetal heart rate between opioid-exposed and non-exposed groups. Mothers with prenatal opioid use had a significantly lower fetal heart rate as compared to mothers without prenatal opioid use, requiring further studies to determine clinical significance.

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