Prenatal opioid exposure (POE) has increased dramatically in the last 10 years, with nearly 100 babies born daily in the United States with Neonatal Opioid Withdrawal Syndrome (NOWS). The impact on long-term outcomes continues to be investigated. Given the proinflammatory state that results from POE, we hypothesized that infants with POE or NOWS diagnoses during the newborn hospitalization would have an altered immune reactivity that persisted into childhood, defined by asthma diagnosis within the first 8 years.
A retrospective cohort design utilizing a comprehensive CERNER HealthFacts U.S. national database was completed, which accesses clinical data from 800 hospitals across the country. ICD-9-CM and ICD-10-CM diagnosis codes were used to identify infants born at term with known POE or NOWS and were compared to healthy control infants with no diagnoses at birth other than normal newborn codes. The incidence of asthma during the first 8 years of life was determined. Descriptive statistics of frequencies and percentages were calculated for all variables. A Chi-Square test was used to examine the association between asthma diagnosis and POE.
A total of 3128 infants were included in the analysis. Approximately 41% were identified as male and 38% identified as female; the remainder were not specified with coding. Almost 52% of subjects were identified as Caucasian. Asthma diagnosis differed significantly by group, X2 (3, n = 3,128) = 12.93 with a p < 0.001.
These emerging results suggest infants with POE may have altered immune reactivity that not only impacts the newborn period but persists into childhood. Those with POE were more likely to be diagnosed with asthma by 8 years of age than infants in the healthy control group. Additional investigations are needed to further characterize the impact POE has on the immune system, so that potential follow up strategies and/or interventions can be established.
Cervantes, Isabella; Shikhar Shrestha; Sharon Ruyak; and Jessie R. Maxwell. "Increased Incidence of Asthma in Children with Prenatal Opioid Exposure." (2020). https://digitalrepository.unm.edu/hsc_2020_pediatric_research/9