Teenage follow-up of neurocognitive and psychosocial functioning of children born to mothers with opiate and polydrug abuse

The aim of the study is to investigate biological-psychosocial interactions in the development of youths born of mothers who used opioids or polydrugs during pregnancy. The youths have been followed since birth, and are between 17 and 22 years of age at the time of the current study. Interviews and investigations of the participants started in February 2013 and ended in June 2014. A total of 98 youths participated, including 50 youths who had been exposed to opioids of polydrugs prenatally, and 48 youths without any know prenatal risk factors. Most of the youths in the risk group have had their upbringing with stable foster- or adoptive parents since before they were one year of age. The youths were investigated with cognitive tests, went through a diagnostic interview concerning current and previous mental health, gave saliva sample for genetic information, took MRI brain scans, and replied to multiple questionnaires concerning psychosocial conditions. In addition, 174 of their caregivers filled out questionnaires on psychosocial conditions concerning both themselves and their participating adolescent. Findings from the study have been presented at several Norwegian conferences, at one Nordic conference and at one international conference. Three international peer reviewed articles have been published, one has been submitted and one more is under production. The findings indicate that youths born of mothers who used opioids or multiple drugs during pregnancy on average have somewhat lower functioning in several areas compared to youths without know prenatal risk factors, for example on average lower cognitive scores or more behavioral or emotional problems. The differences between the groups increased up 8-9 years of age. There is a large overlap between the groups in all areas, and especially large variations within the risk group. Thus, there are both youths who is managing very well and youths with multiple problems within the risk group. It is therefore difficult to generalize about the developmental trajectory of children born of mothers with poly-drug use during pregnancy. The mean differences do however indicate that it is important with long term follow up of children born of mothers with poly-drug abuse during pregnancy. The present study contributes with knowledge in a field were there has been a lack of longitudinal and neuroanatomical studies.

Children born to mothers with opioid and polysubstance abuse problems are at increased risk of regulatory and neuropsychological difficulties. This has been established primarily by the study of infants and preschoolers. Problems may be identifiable early in development, but the neurocognitive and regulatory domains affected are not well-developed until adolescence and young adulthood. Still, there is a lack of studies assessing long term outcomes. Questionnaires and interview data point to a high risk o f externalizing problems and criminal, substance abuse and unemployment problems. The extent to which this is associated with central nervous system (CNS) alterations, neuropsychological difficulties, and/or environmental factors is unknown. No study has assessed the teenage neurocognitive and psychosocial development of children born to opioid-dependent mothers. Many problems in affected neuropsychological and regulatory domains may first become evident at this age, and the parental substance abuse may a lter the children`s own vulnerability to addiction to drugs of abuse, surfacing in teenage years. Regulatory, neuropsychological and drug use problems can partly be explained by social-environmental correlates of maternal substance abuse, but there may al so be potent biological foundations, including CNS alterations. Prenatally exposed children growing up under optimized conditions also exhibit problems and prenatal substance exposure may alter gene expression in brain regions involved in the reinforcing effects of drugs to increase later addiction liability. We will study the interaction of risk factors associated with maternal substance abuse, focusing on mediating and moderating variables influencing the developmental outcome in teenagers/young adults .