Neurobehavioral Profiles in Opioid-Exposed and Unexposed Neonates

Abstract

Objective: To describe distinctive profiles of neurobehavior in opioid-exposed and unexposed neonates.

Study design: The Outcomes of Babies with Opioid Exposure study is a multisite, prospective, observational study in neonates born at term with opioid exposure and unexposed controls. As part of the Outcomes of Babies with Opioid Exposure study protocol, certified examiners administered the NeoNatal Neurobehavioral Scales, second edition (NNNS-II) before 6 weeks postnatal age. We used latent profile analysis to determine distinctive classes of neurobehavior and linear mixed effect models to compare NNNS-II scores by exposure status.

Results: The study included 291 neonates with NNNS-II, 194 exposed and 97 unexposed. Latent profile analysis resulted in 4 unique classes. Class 4 showed the most signs of stress and included almost exclusively exposed neonates. Scores for exposed neonates were significantly different than unexposed neonates on most NNNS-II subscales. In addition to opioids, associations were found between profile membership and prenatal exposure to benzodiazepines, e-cigarettes/tobacco, and selective serotonin reuptake inhibitors.

Conclusions: Neonates with prenatal exposure to opioids and other psychotropic substances have distinctive patterns of neurobehavior. Additional follow-up is needed to determine if these neurobehavioral differences serve as a marker for future problems with attention and behavior.

Gov registration: NCT04149509.

Keywords: NNNS; antenatal opioid exposure; neonatal neurobehavior; neonatal opioid withdrawal syndrome; prenatal opioid exposure.