Cognitive Outcomes of Young Children After Prenatal Exposure to Medications for Opioid Use Disorder

Key Points Question Is prenatal exposure to methadone or buprenorphine for treatment of opioid use disorder during pregnancy associated with differences in cognitive development in young children? Findings This systematic review and meta-analysis of nearly 50 years of observational research, analyzing 27 studies that included 1086 children, showed an overall negative association of exposure to methadone or buprenorphine with cognitive development. However, subanalyses revealed that this outcome may be associated with imbalances in the recruitment of mothers with different socioeconomic and educational backgrounds, levels of tobacco use in pregnancy, and fetal growth characteristics. Meaning The findings of this study suggest that poor recruitment of comparison groups could prevent conclusive determination regarding the association of prenatal exposure to methadone or buprenorphine with cognitive outcomes. Prenatal exposure to methadone or buprenorphine may have minimal direct associations when confounders, particularly tobacco use, are controlled.