Prenatal opioid exposure increase long-term impact on immunity in pediatric population: JAMA

A recent retrospective study published in the Journal of American Medical Association unveiled a concerning association between prenatal opioid exposure (POE) and the alterations in the fetal immune system that potentially affect the long-term health of exposed children. This study encompassing health records of a vast cohort of 401,462 children born between 2003 and 2018 in the Western Australia, sheds light on the impacts of opioid exposure during pregnancy.

During the study period from August 30, 2022 to February 27, 2023, the study investigated the link between POE and subsequent risks of hospitalization and emergency department visits for immune-related conditions. The outcomes indicated that neonates with POE, constituting 0.4% of the cohort, exhibited a higher likelihood of preterm birth, low birth weight, and co-exposure to cigarette smoke.

Perinatal opioid exposure was associated with a 62% increased risk of perinatal infection and an astonishing 11.91 times higher risk of eczema and dermatitis compared to non-exposed neonates. Neonatal abstinence syndrome resulting from opioid withdrawal in newborns was linked to a nearly threefold increase in the risk of both perinatal infection and eczema/dermatitis.

Prenatal opioid exposure was also found to be linked to a 44% increased risk of childhood asthma. But, no significant associations were observed with allergies, anaphylaxis or autoimmune conditions. By differentiating between opioids prescribed for pain and those used to treat opioid use disorder (OUD), the study observed that while POE from pain-related opioids to increase the risk of infection, OUD-related opioids were linked with a higher risk of childhood eczema and dermatitis.

These findings underscore the need for further research into the impact of opioid-induced changes on the immune system during pregnancy. Understanding the mechanisms behind opioid-induced immune dysregulation could be important to develop interventions to reduce the long-term health risks in children exposed to opioids in utero.

Reference:

Kelty, E., Rae, K., Jantzie, L. L., Wyrwoll, C. S., & Preen, D. B. (2024). Prenatal opioid exposure and immune-related conditions in children. JAMA Network Open, 7(1), e2351933. https://doi.org/10.1001/jamanetworkopen.2023.51933