Hostname: page-component-8448b6f56d-c4f8m Total loading time: 0 Render date: 2024-04-18T06:45:30.888Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatric problems of children exposed to opiates in utero – a descriptive study

Published online by Cambridge University Press:  13 June 2014

Ciaran Clarke  and
Carol Fitzpatrick
Carol Fitzpatrick
Affiliation:
Department of Child and Adolescent Psychiatry, Mater Misericordiae Hospital, Eccles Street, Dublin 7, Professor of Child and Adolescent Psychiatry, University College Dublin, Ireland
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: To describe the psychosocial and clinical characteristics of children referred to a community-based child and adolescent mental health service, whose mothers reported that they took opiates during the pregnancy.

Methods: In a retrospective study, the case notes of all children whose mothers reported that they had been exposed to opiates in utero, and who were referred to the Department of Child and Family Psychiatry, Mater Hospital, between 2001–2003, were identified by maternal reports. Information was obtained on age, gender, referral source, socio-economic group, family type, number of siblings, involvement of community care services, nature of presenting problems, diagnosis, interventions offered, and treatment difficulties. Information was recorded anonymously.

Results: 15 children were identified, of whom nine were male. Most were found to be living with their mother alone or with their mother and a partner, and to be socially and financially disadvantaged. Their presenting complaints usually involved combinations of aggressive, hyperactive, and oppositional behaviour. Diagnoses included ADHD, a speech and language disorder, and an axis II disorder. Interventions were frequently unsuccessful because of parents' difficulties with attending appointments, and because of instability in the families' living arrangements.

Conclusions: These children, due to a complex interplay of biological and psychosocial adversity, are at serious risk of ongoing psychiatric disorders in childhood and adolescence, and for adverse outcomes in adult life. A prospective cohort study of all children born to opiatedependent mothers is necessary to quantify the level of risk and identify resilience factors.

Keywords

Child psychiatryOpiatesPregnancy
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 22 , Issue 4 , December 2005 , pp. 121 - 123
Copyright
Copyright © Cambridge University Press 2005

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

1.Finnegan, LP, Connaughton, JF Jr, Kron, RE, Emich, JP. Neonatal abstinence syndrome: assessment and management. Addict Dis 1975; 2:141–58.Google ScholarPubMed
2.Kaltenbach, K, Finnegan, LP. Neonatal abstinence syndrome, pharmacotherapy and developmental outcome. Neurobehav Toxicol Teratol 1986; 8: 353–5.Google ScholarPubMed
3.Olofsson, M, Buckley, W, Andersen, GE, Friis-Hansen, B. Investigation of 89 children born by drug-dependent mothers. II. Follow-up 1-10 years after birth. Acta Paediatr Scand 1983; 72: 407–10.CrossRefGoogle ScholarPubMed
4.Hutchings, DE. Methadone and heroin during pregnancy: a review of behavioral effects in human and animal offspring. Neurobehav Toxicol Teratol 1982; 4: 429–34.Google ScholarPubMed
5.Hayes, JS, Lampart, R, Dreher, MC, Morgan, L. Five-year follow-up of rural Jamaican children whose mothers used marijuana during pregnancy. West Indian Med J 1991; 40: 120–3.Google ScholarPubMed
6.Kelly, A, Carvalho, M, Teljeur, C. Prevalence of opiate use in Ireland 2000–2001, 2003.Google Scholar
7.Smyth, BP, O'Brien, M. Children attending addiction treatment services in Dublin, 1990–1999. Eur Addict Res 2004; 10: 68–74.CrossRefGoogle ScholarPubMed
8.Goodman, G, Hans, SL, Cox, SM. Attachment behavior and its antecedents in offspring born to methadone-maintained women. Opiate systems in mother and infant primates coordinate intimate contact. J Clin Child Psychol 1999; 28: 58–69.CrossRefGoogle Scholar
9.Kalin, NH, Shelton, SE, Lynn, DE. Opiate systems in mother and infant primates co-ordinate intimate contact during reunion. Psychoneuroendocrinology 1995; 20: 735–42.CrossRefGoogle Scholar
10. National Statistics – Methods and quality – socio-economic-classification 2003. Available from www.statistics.gov.uk/methods_quality/ns_sec/default.aspGoogle Scholar
11.Kim-Cohen, J, Caspi, A, Moffitt, TE, Harrington, H, Milne, BJ, Poulton, R. Prior juvenile diagnoses in adults with mental disorder: developmental follow-back of a prospectivelongitudinal cohort. Arch Gen Psychiatry 2003; 60: 709–17.CrossRefGoogle ScholarPubMed
12.Wilson, GS, McCreary, R, Kean, J, Baxter, JCThe development of preschool children of heroin-addicted mothers: a controlled study. Pediatrics 1979; 63: 135–41.CrossRefGoogle ScholarPubMed
13.Ornoy, A. The effects of alcohol and illicit drugs on the human embryo and fetus. Isr J Psychiatry Relat Sci 2002; 39: 120–32.Google ScholarPubMed
14.Davis, E, Fennoy, I, Laraque, D, Kanem, N, Brown, G, Mitchell, J. Autism and developmental abnormalities in children with perinatal cocaine exposure. J Natl Med Assoc 1992; 84: 315–9.Google ScholarPubMed
15.Schubiner, H, Tzelepis, A, Milberger, S, Lockhart, N, Kruger, M, Kelley, BJ, Schoener, EP. Prevalence of attention-deficit/hyperactivity disorder and conduct disorder among substance abusers. J Clin Psychiatry 2000; 61: 244–51.CrossRefGoogle ScholarPubMed
16.Eaves, CS. Heroin use among female adolescents: the role of partner influence in path of initiation and route of administration. Am J Drug Alcohol Abuse 2004; 30: 21–38.CrossRefGoogle ScholarPubMed
17.Guo, X, Spencer, JW, Suess, PE, Hickey, JE, Better, WE, Herning, RI. Cognitive brain potential alterations in boys exposed to opiates: in utero and lifestyle comparisons. Addict Behav 1994; 19:429–41.CrossRefGoogle Scholar
18.Ornoy, A, Michailevskaya, V, Lukashov, I, Bar-Hamburger, R, Harel, S. The developmental outcome of children born to heroin-dependent mothers, raised at home or adopted. Child Abuse Negl 1996; 20: 385–96.CrossRefGoogle ScholarPubMed
19.Dawe, S, Harnett, PH, Rendalls, V, Staiger, P. Improving family functioning and child outcome in methadone maintained families: the Parents Under Pressure programme. Drug Alcohol Rev 2003; 22: 299–307.CrossRefGoogle ScholarPubMed
20.Johnson, HL, Glassman, MB, Fiks, KB, Rosen, TS. Resilient children: individual differences in developmental outcome of children born to drug abusers. J Genet Psychol 1990; 151: 523–39.CrossRefGoogle ScholarPubMed
21.Moe, V. Foster-placed and adopted children exposed in utero to opiates and other substances: prediction and outcome at four and a half years. J Dev Behav Pediatr 2002; 23:330–9.CrossRefGoogle ScholarPubMed
22.McNichol, T, Tash, C. Parental substance abuse and the development of children in family foster care. Child Welfare 2001; 80: 239–56.Google ScholarPubMed
23.Ornoy, A. The impact of intrauterine exposure versus postnatal environment in neurodevelopmental toxicity: long-term neurobehavioral studies in children at risk for developmental disorders. Toxicol Lett 2003; 140–141: 171–81.CrossRefGoogle ScholarPubMed
24.Soepatmi, S. Developmental outcomes of children of mothers dependent on heroin or heroin/methadone during pregnancy. Acta Paediatr Suppl 1994; 404: 36–9.CrossRefGoogle ScholarPubMed