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Science of Religion
BODY & BRAIN
Opioids linked to
babies’ small heads
Drug use in pregnancy might
impair a child’s brain growth
BY AIMEE CUNNINGHAM
Babies born dependent on opioids have
smaller heads than babies not exposed
to the drugs in the womb.
The finding, published online
December 10 in Pediatrics, raises concerns that the drugs impair brain growth
during development, researchers say.
Pregnant women who use opioids,
including opioids to treat addiction, pass
the drugs through the bloodstream to
their babies. Infants can become dependent on the drugs in the womb and experience withdrawal symptoms after birth.
This withdrawal, known as neonatal
abstinence syndrome, or NAS, is marked
by excessive crying, tremors or difficulty
sleeping or feeding (SN: 6/10/17, p. 16).
Researchers compared the head sizes
of almost 860 babies born from 2014 to
2016, half with NAS and half from mothers who had no opioids while pregnant.
Newborns with NAS had a head circumference nearly a centimeter smaller, on
average, than babies not exposed to the
drugs. Thirty percent of the NAS babies
had especially small heads compared with
only 12 percent of babies without NAS.
A smaller head is a possible sign of a
smaller brain. So for NAS babies who later
have learning and behavioral problems, a
contributing factor may be the effect of
opioids on brain growth, says neonatolo-gist Jonathan Davis of Floating Hospital
for Children at Tufts Medical Center in
Boston. It is essential to determine “the
actual impact of the smaller heads on
how these children are developing,” says
Davis, who wasn’t involved in the study.
The researchers found that 372 of the
NAS babies, or 87 percent, had moms who
took the opioids buprenorphine or meth-
adone during pregnancy to treat their
addiction, suggesting that the treatment
can also contribute to small head size.
Called medication-assisted treatment,
the therapy, which reduces cravings and
withdrawal symptoms without producing a high, is recommended for addicted
pregnant women because it’s generally
thought that withdrawing from opioids
while pregnant could harm the fetus or
put mothers at risk of relapse.
But that recommendation largely
stems from two case studies in the 1970s,
says Craig Towers, coauthor of the new
paper. Studies since then have found that
gradual withdrawal during pregnancy
does not harm the fetus, he says.
Still, the treatment is the first step for
addicted pregnant women. It should be
a woman’s choice whether to continue
with medication-assisted treatment or
to undergo a medically supervised withdrawal, says Towers, a maternal fetal
medicine specialist at the University of
Tennessee Medical Center in Knoxville.
If a woman has struggled with a past
attempt at withdrawal, then the treatment may be safer, he says. s