Long-term outcomes after prenatal heroin and poly-substance exposure. Results from 20 years follow up

There is almost a total lack of studies investigating the longitudinal outcome for children born of mothers with opioid and poly-substance abuse during pregnancy. The present study followed up the children previously studied and presented by Kari Slinning and Vibeke Moe. At an average age of 8 ½ years, the children completed cognitive tests (WISC), and caregivers and schoolteachers filled out questionnaires about the children’s behavior (ASEBA). In young adulthood (ages 17 to 21), they were administered 10 neuropsychological tests, completed diagnostic interviews and questionnaires about their behavior in addition to brain imaging. This presentation will concentrate on the cognitive and behavioral findings. The children born of mothers who used heroin and poly-substances during pregnancy had worse IQ at 8 ½ years and at youth than the comparison group. The boys in the risk group had significantly and stable worse cognitive functioning than the comparison group from they were 1 year of age, whereas there were increasing differences over time for the girls up until 8 ½ years of age. At youth, the risk group had cognitive functioning within the normal range compared to population norms, but significantly worse than the comparison group. The differences in cognitive functioning seemed to be general rather than limited to specific problems such as executive functioning. There was a tendency for youths with few or early changes of caregivers, or being born of mother using the least number of drugs during pregnancy, to have the best cognitive outcomes. Caregivers reports indicated that there was also an increase in behavioral problems in the risk group relative to the comparison group up until the children was 8 ½ years old. Both caregivers and teachers reported significant more problems in the risk group than the comparison group across a wide range of behavioral areas, particular with regard to attention problems. The group differences in behavioral and attentional problems were not significantly greater, and some were even significantly smaller than the group differences in general cognitive abilities. The findings indicate that children born of mothers with opioid and poly-substance misuse during pregnancy have worse functioning in multiple areas, e.g. general cognitive functioning, behavior and attention. The findings indicate that these problems do not wane, but rather increase over time, relative to comparison groups.