Key Summary
- Children exposed to opioids before birth are more likely to face vision issues and lower cognitive performance.
- The review analysed data from over 31,000 exposed children and 5.4 million unexposed children across 10 countries.
- Researchers advocate for early, joined-up support across healthcare and education.
Children exposed to opioids before birth face heightened risks of vision impairment, attention difficulties, and learning challenges during their school years, according to a study.
Researchers from the University of Glasgow in collaboration with the University of Dundee analysed findings from 27 research papers published over the past decade.
Covering more than 31,000 opioid-exposed children and over 5.4 million unexposed children across 10 countries in Europe, North America, Australasia, and Asia, it offers the most comprehensive assessment to date on how prenatal opioid exposure impacts children aged five to 18.
By examining data encompassing illicit opioid use, prescribed medications for opioid use disorder such as methadone and buprenorphine, and neonatal withdrawal diagnoses, the researchers found consistent evidence linking exposure to several developmental hurdles.
Visually affected children showed higher rates of conditions such as strabismus (eye misalignment), nystagmus (involuntary eye movement), and reduced visual acuity.
In terms of neurodevelopment and cognition, the review revealed increased hyperactivity, attention difficulties, and a higher likelihood of Attention Deficit Hyperactivity Disorder (ADHD).
Exposed children also showed differences in memory, verbal IQ, and overall academic achievement, with emerging evidence indicating that they were twice as likely to fall below expected literacy and numeracy standards by early adolescence.
While evidence regarding physical health, structural brain development, and emotional wellbeing remains inconclusive, researchers emphasised that pregnant women taking prescribed opioids should never stop or alter their medication without consulting a doctor.
Commenting on the results, Dr Louise Marryat, LKAS Senior Research Fellow at Glasgow’s School of Health and Wellbeing, said: “While we cannot say that prenatal opioid exposure directly causes these outcomes -- and we have limited data on dosage, timing, and specific types of exposure -- the consistency of findings suggests that these children face real developmental challenges.
“Families affected by opioid use face complex challenges. Policy interventions that prioritise family-centered, supportive approaches can improve outcomes, alongside joined-up care across health, education, and social services. Early identification of vision and neurodevelopmental needs will ensure these children receive timely, long-term help.”
Co-author Alison McFadden, Professor of Mother and Infant Public Health at the University of Dundee, added that while the study highlights critical long-term outcomes, further research is needed to understand the full range of effects, particularly for children over 12 years of age.
The study, titled ‘Prenatal opioid exposure, and health, social, and educational outcomes for school-aged children: a systematic review,’ was funded by a UKRI Future Leaders Fellowship.
