Abstract
Background and Aims
Our understanding of the long‐term safety of prenatal exposure to Opioid Maintenance Treatment (OMT) is insufficient. We compared childhood morbidity (0‐3 years) between OMT‐exposed and relevant comparison groups.
Design
Nation‐wide, registry‐based cohort study. Registries on reproductive health, addiction treatment, hospitalization, and death were linked using identification numbers.
Setting
The Czech Republic (2000‐14).
Participants
Children with different prenatal exposure: i) Mother in OMT during pregnancy (OMT; n=218), ii) Mother discontinued OMT before pregnancy (OMT‐D; n=55), iii) Mother with opioid use disorder, but not in OMT during pregnancy (OUD; n=85), and iv) Mother in the general population (GP) (n=1,238,452)
Measurements
Episodes of hospitalisation were observed as outcomes. Information on in‐patient contacts, length of stay, and diagnoses (International Classification of Diseases version 10) were assessed. Binary logistic regressions were conducted to estimate the associations between OMT exposure and the outcomes, crude and adjusted for the socioeconomic status and smoking.
Findings
No significant differences were found in the overall proportion of hospitalisation among OMT exposed children, children of OMT‐D and children of women with OUD (54.1%, 95% confidence interval: 47.3%‐60.1%, 47.3% (33.9%‐61.1%), 51.8% (40.7%‐62.6%)), while the proportion was significantly lower (35.8% (35.7%‐35.8%)) in the GP. There were no significant differences in risk of specific diagnoses between OMT‐ exposed children, children of OMT‐D, and children of women with OUD. In the adjusted analyses, differences between OMT‐ exposed and children in the GP were still present for infections and parasitic diseases (OR=2.0, 1.4‐2.7), diseases of the digestive system (OR= 1.7; 1.2‐2.6), and disease of the skin and subcutaneous tissue (OR= 1.9; 1.2‐3.2).
Conclusion
This study did not find clear evidence for an increase in risk of morbidity during the first three years of life in children with prenatal opioid maintenance treatment exposure compared with children of women who discontinued such treatment before pregnancy or suffered from opioid use disorder without this treatment. Compared the general population, there appears to be an increased risk of hospitalisations for infectious, gastrointestinal and skin diseases.