Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-22T22:23:06.341Z Has data issue: false hasContentIssue false
  • English
  • Français

Head circumference in infants with nonopiate-induced neonatal abstinence syndrome

Published online by Cambridge University Press:  01 July 2020

Daisaku Morimoto Open the ORCID record for Daisaku Morimoto [Opens in a new window] ,
Yosuke Washio ,
Kazuki Hatayama ,
Tomoka Okamura ,
Hirokazu Watanabe ,
Junko Yoshimoto  and
Hirokazu Tsukahara
Daisaku Morimoto
Affiliation:
Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Yosuke Washio*
Affiliation:
Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Kazuki Hatayama
Affiliation:
Department of Pediatrics, Women and Infants Hospital of Rhode Island, Providence, Rhode Island, USA
Tomoka Okamura
Affiliation:
Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Hirokazu Watanabe
Affiliation:
Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Junko Yoshimoto
Affiliation:
Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
Hirokazu Tsukahara
Affiliation:
Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
*
Author for correspondence: Yosuke Washio, Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

No relationship has been reported between nonopiate neonatal abstinence syndrome (NAS) and anthropometric indices, including head circumference (HC). The purpose of this study was to determine the relationship between maternal nonopioid drug use and HC at birth in neonates with NAS.

Methods

This retrospective observational study included neonates born between January 1, 2010 and March 31, 2019, whose mothers had been taking antipsychotic, antidepressant, sedative, or anticonvulsant medications. The outcome measures were HCs of NAS infants and controls.

Results

Of 159 infants, 33 (21%) were diagnosed with NAS. There was no maternal opioid use among mothers during pregnancy. The HCs in the NAS group were significantly smaller than those in the control group. The median z-scores for HC at birth were −0.20 and 0.29 in the NAS group and the control group, respectively (P = .011). The median HCs at birth were 33.0 and 33.5 cm in the NAS group and the control group, respectively. Multivariate analysis revealed that maternal antipsychotic drug use and selective serotonin reuptake inhibitors were independently associated with NAS (P < .001 and P = .004, respectively). Notably, benzodiazepine use and smoking were not independent risk factors.

Conclusions

The results suggest an association between maternal antipsychotic drug use and NAS, which was further associated with decreased HC. Careful monitoring of maternal drug use should be considered to improve fetal outcomes.

Keywords

Modified Finnegan scoreanthropometric indexmaternal mental healthneonatal abstinence syndromematernal medication
Type
Original Research
Information
CNS Spectrums , Volume 26 , Issue 5 , October 2021 , pp. 509 - 512
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kocherlakota, P. Neonatal abstinence syndrome. Pediatrics. 2014;134(2):e547–e561.CrossRefGoogle ScholarPubMed
Finnegan, LP, Connaughton, JF, Kron, RE, et al. Neonatal abstinence syndrome: assessment and management. Addict Dis. 1975;2(1–2):141–158.Google ScholarPubMed
Patrick, SW, Schumacher, RE, Benneyworth, BD, et al. Neonatal abstinence syndrome and associated health care expenditures: United States, 2000–2009. JAMA. 2012;307(18):1934–1940.CrossRefGoogle ScholarPubMed
Davies, H, Gilbert, R, Johnson, K, et al. Neonatal drug withdrawal syndrome: cross-country comparison using hospital administrative data in England, the USA, Western Australia and Ontario, Canada. Arch Dis Child Fetal Neonatal Ed. 2016;101(1):F26–F30.CrossRefGoogle ScholarPubMed
Towers, C, Hyatt, B, Visconti, K, et al. Neonatal head circumference in newborns with neonatal abstinence syndrome. Pediatrics. 2019;143(1):e20180541.CrossRefGoogle ScholarPubMed
Visconti, K, Hennessy, K, Towers, C, et al. Chronic opiate use in pregnancy and newborn head circumference. Am J Perinatol. 2015;32(1):27–32.CrossRefGoogle ScholarPubMed
von der Hagen, M, Pivarcsi, M, Liebe, J, et al. Diagnostic approach to microcephaly in childhood: a two-center study and review of the literature. Dev Med Child Neurol. 2014;56(8):732–741.CrossRefGoogle ScholarPubMed
Fattal-Valevski, A, Toledano-Alhadef, H, Leitner, Y, et al. Growth patterns in children with intrauterine growth retardation and their correlation to neurocognitive development. J Child Neurol. 2009;24(7):846–851.CrossRefGoogle ScholarPubMed
Watemberg, N, Silver, S, Harel, S, et al. Significance of microcephaly among children with developmental disabilities. J Child Neurol. 2002;17(2):117–122.CrossRefGoogle ScholarPubMed
Japan Society for Neonatal Health and Development. Standard birth indices for gestational age. http://jspe.umin.jp/taikakubirthlongcrossv1.xlsx. Accessed February 29, 2020.Google Scholar
Walhovd, KB, Moe, V, Slinning, K, et al. Volumetric cerebral characteristics of children exposed to opiates and other substances in utero. Neuroimage. 2007;36(4):1331–1344.CrossRefGoogle ScholarPubMed
Sirnes, E, Oltedal, L, Bartsch, H, et al. Brain morphology in school-aged children with prenatal opioid exposure: A structural MRI study. Early Hum Dev. 2017;106–107:33–39.CrossRefGoogle ScholarPubMed
Bodén, R, Lundgren, M, Brandt, L, et al. Antipsychotics during pregnancy. Arch Gen Psychiatry. 2012;69(7):715–721.CrossRefGoogle ScholarPubMed
Lewis, AJ, Galbally, M, Opie, G, et al. Neonatal growth outcomes at birth and one month postpartum following in utero exposure to antidepressant medication. Aust N Z J Psychiatry. 2010;44(5):482–487.CrossRefGoogle ScholarPubMed
Wisner, KL, Bogen, DL, Sit, D, et al. Does fetal exposure to SSRIs or maternal depression impact infant growth? Am J Psychiatry. 2013;170(5):485–493.CrossRefGoogle ScholarPubMed
Hudak, ML, Tan, RC, The Committee on Drugs, The Committee on Fetus and Newborn. Neonatal drug withdrawal. Pediatrics. 2012;129(2):e540–e560.CrossRefGoogle ScholarPubMed
Veroniki, AA, Rios, P, Cogo, E, et al. Comparative safety of antiepileptic drugs for neurological development in children exposed during pregnancy and breast feeding: a systematic review and network meta-analysis. BMJ Open. 2017;7(7):1–11.CrossRefGoogle ScholarPubMed
Prady, SL, Hanlon, I, Fraser, LK, et al. A systematic review of maternal antidepressant use in pregnancy and short- and long-term offspring’s outcomes. Arch Womens Ment Health. 2018;21(2):127–140.Google Scholar
Gentile, S, Fusco, ML. Neurodevelopmental outcomes in infants exposed in utero to antipsychotics: A systematic review of published data. CNS Spectr. 2017;22(3):273–281.CrossRefGoogle ScholarPubMed
Huybrechts, KF, Bateman, BT, Desai, RJ, et al. Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: cohort study. BMJ. 2017;358:j3326.CrossRefGoogle ScholarPubMed
Oga, EA, Mark, K, Coleman-Cowger, VH. Cigarette smoking status and substance use in pregnancy. Matern Child Health J. 2018;22(10):1477–1483.CrossRefGoogle ScholarPubMed
Miyazaki, M, Suzuki, S. Influence of smoking habits on mental status in Japanese women during the first trimester of pregnancy. J Matern Neonatal Med. 2019;1:1–4.Google Scholar
Kharkova, OA, Grjibovski, AM, Krettek, A, et al. Effect of smoking behavior before and during pregnancy on selected birth outcomes among singleton full-term pregnancy: A Murmansk county birth registry study. Int J Environ Res Public Health. 2017;14(8):pii: E867.CrossRefGoogle ScholarPubMed
Jaddoe, VWV, Verburg, BO, de Ridder, MAJ, et al. Maternal smoking and fetal growth characteristics in different periods of pregnancy: the Generation R Study. Am J Epidemiol. 2007;165(10):1207–1215.CrossRefGoogle ScholarPubMed
Roza, SJ, Verburg, BO, Jaddoe, VWV, et al. Effects of maternal smoking in pregnancy on prenatal brain development: the Generation R study. Eur J Neurosci. 2007;25(3):611–617.CrossRefGoogle ScholarPubMed
Inoue, S, Naruse, H, Yorifuji, T, et al. Impact of maternal and paternal smoking on birth outcomes. J Public Heal (United Kingdom). 2017;39(3):557–566.Google ScholarPubMed
Tsuda, Y, Saruwatari, J, Yasui-Furukori, N. Meta-analysis: The effects of smoking on the disposition of two commonly used antipsychotic agents, olanzapine and clozapine. BMJ Open. 2014;4(3):e004216.CrossRefGoogle ScholarPubMed
Supplementary material: File

Morimoto et al. supplementary material

Table Appendix

Download Morimoto et al. supplementary material(File)
File 23.6 KB