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Prenatally buprenorphine-exposed children: health to 3 years of age

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Abstract

Our prospective study is among the first attempts to examine the health of prenatally buprenorphine-exposed children after neonatal age and to determine the types of child maltreatment in this patient group. The study population included 102 children (61/41 Caucasian males/females) who had a positive urine screen for buprenorphine as a newborn. In addition to buprenorphine, the children were also prenatally exposed to other substances. The data were collected by pediatricians in follow-up visits until 3 years of age and from medical records. Ten prenatally buprenorphine-exposed children (10 %) had some birth defect. The study children had slightly more major anomalies than newborns on average in Finland (3.4 %). Eye disorders (nystagmus, opticus atrophy, and strabismus) occurred in 11 % of children. One child was diagnosed with hepatitis C transmission. One female died of sudden infant death syndrome (SIDS), and one male died of congenital heart disease. Pediatricians submitted altogether 70 reports to child welfare services of suspected maltreatment. Of these reports, 45 (64 %) involved medical neglect. Physical abuse was suspected in four reports.

Conclusion: We suggest that prenatally buprenorphine-exposed children have several types of problems with their health at toddler age and that they are susceptible to child maltreatment, especially to medical neglect.

What is Known:

Buprenorphine is used in the treatment of opioid addiction in pregnancy. Prenatally buprenorphine-exposed newborns develop neonatal abstinence syndrome (NAS) in about 60 % of cases. Data on the health and maltreatment of these children after neonatal age are limited.

What is New:

Prenatally buprenorphine-exposed children can have several types of problems with their physical health by 3 years of age, and they are susceptible to child maltreatment, especially to medical neglect.

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Abbreviations

ADHD:

Attention deficit hyperactivity disorder

CHD:

Congenital heart defect

CPS:

Child protective services

DLD:

Delayed language development

DSM-IV:

Diagnostic and statistical manual of mental disorders 4th edition

ECC:

Early childhood caries

FASD:

Fetal alcohol spectrum disorders

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

HIV:

Human immunodeficiency virus

HUCH:

Helsinki University Central Hospital

NAS:

Neonatal abstinence syndrome

PAPA:

Pre-school age psychiatric assess

PDA:

Patent ductus arteriosus

SIDS:

Sudden infant death syndrome

SLI:

Specific language impairment

SSRI:

Selective serotonin reuptake inhibitor

UNODC:

United Nations Office on Drug and Crime

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Funding

This study was supported by the Foundation for Pediatric Research, Helsinki, Finland.

Financial disclosure

The authors have no financial relationships relevant to this article to disclose.

Conflict of interest

The authors declare that they have no competing interests.

Authors’ contributions

All authors made substantial contribution in study´s design. Kaisa Kivistö carried out collecting the data from medical records and had major responsibility in writing the manuscript. Sarimari Tupola and Satu Kivitie-Kallio interviewed and examined the patients in pediatrician´s appointments and participated in drafting the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kaisa Kivistö.

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Communicated by Beat Steinmann

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Kivistö, K., Tupola, S. & Kivitie-Kallio, S. Prenatally buprenorphine-exposed children: health to 3 years of age. Eur J Pediatr 174, 1525–1533 (2015). https://doi.org/10.1007/s00431-015-2562-0

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