Children born dependent on opioids are more likely to perform poorly in school as they get older, according to a report by Australian researchers.
The study, published in the journal Pediatrics, was the first to examine the long-term academic outcomes of children with a history of neonatal abstinence syndrome. NAS is a group of health complications that occur in newborns exposed to opioids while in the mother’s womb.
Infants with NAS often experience diarrhea, high-pitched crying, seizures, slow weight gain and trembling.
“NAS is strongly associated with poor and deteriorating school performance,” the authors stated in the study. “Parental education may decrease the risk of failure. Children with NAS and their families must be identified early and provided with support to minimize the consequences of poor educational outcomes.”
Researchers examined school test data for third-, fifth- and seventh-grade students born in New South Wales, Australia, between 2000 and 2006. The study compared the standardized test scores of 2,234 children with NAS with those of 4,330 kids who do not have NAS and those of 598,265 other New South Wales children.
The results suggested an association exists between the diagnosis of NAS and poorer performance in literacy and math. Mean test scores for third-grade children with NAS were significantly lower than those of their peers without NAS.
By the seventh grade, children with NAS had lower standardized test scores than those of fifth-grade children without NAS. Forty-four percent of seventh graders with NAS failed to meet national minimum test standards in at least one category.
”Although this study was conducted in Australia, the high risk of poor academic performance in this vulnerable group of children is applicable to all countries,” the study’s authors concluded. “Strategies to address this risk and prevent poor adult outcomes and intergenerational vulnerability must be urgently addressed.”
Neonatal Abstinence Syndrome: Long-Term Effects
The study’s authors noted that poor academic performance can lead to depression in women, criminal activity and drug use. Also, children who cannot read at expected levels by the third grade are less likely to enroll in college or graduate high school.
Children born with NAS may have a mother addicted to opioids such as oxycodone, fentanyl or methadone. Families affected by substance use disorders may be more socially chaotic, according to the study. Kids in these families may experience poverty, poor nutrition and poor parenting.
The authors also cited a study that examined the learning abilities of children born to heroin-using mothers. Those aged five to 12 who were raised in foster homes had better intellectual and learning abilities than those of children who remained with their biological families.
Nearly half of children in New South Wales born to methadone-using mothers are removed from their biological parents shortly after birth. Twenty-five percent of these children are removed by age five.
Neonatal Abstinence Syndrome in the United States
The number of babies born with NAS in the United States has grown rapidly since 1999.
The Centers for Disease Control and Prevention drew data from the Healthcare Cost and Utilization Project to examine trends in NAS incidence. Among the 28 states with publicly available HCUP data from 1999 to 2013, NAS incidence increased by 300 percent.
More than 29.9 million hospital births occurred from 1999 to 2013 in the states included in the CDC report. More than 74,000 of these births involved NAS.
Florida experienced 2,487 cases of NAS among babies born in 2015, according to the Florida Agency for Healthcare Administration. From 2014 to 2015, the number of Florida newborns with NAS increased by 30 percent.
Putnam, Nassau and Sarasota counties had the highest rates of NAS births in Florida, according to the Florida Agency for Healthcare Administration. NAS rates were higher than the state average in 25 of 67 Florida counties.
The number of NAS cases in Tennessee has also significantly increased over the years. In 1999, Tennessee experienced 55 inpatient hospitalizations involving NAS, according to the Tennessee Department of Health. In 2011, the number of NAS cases in the state reached 672.