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Background <p>There is a strong recommendation for opioid replacement therapy (ORT) in pregnant women dependent on opioids. Using drugs and alcohol in pregnancy is a well-documented risk factor for later neurodevelopmental impairment, and the infants have reduced quality of their early motor behaviour at the age of 3–4 months corrected age (CA). Growing evidence indicates that ORT exposure in utero has negative long-term effects on the child but whether ORT-exposed infants have reduced quality of early motor behaviour has never been studied. The primary aim of this study was to examine early motor behaviour at 3–4 months CA in infants born to mothers in ORT during pregnancy, infants exposed to alcohol and/or drugs and unexposed infants. Secondary, we aimed to estimate odds for reduced motor behaviour in the three groups.</p> Methods <p>In this prospective cohort study, Children Exposed to Alcohol and/or Drugs in Intrauterine Life (CEADIL), we used cross-sectional data to compare a group of infants exposed to ORT during pregnancy (ORT group, <i>n</i> = 15), a group of infants exposed to alcohol and/or drugs during pregnancy (CEADIL group, <i>n</i> = 99) and a group of healthy unexposed infants (control group, <i>n</i> = 105). Outcome measures were Motor Optimality Score-Revised (MOS-R) and the Alberta Infant Motor Scale (AIMS) at 3–4 months CA.</p> Results <p>The median MOS-R score was 26 (IQR 22-28) in the ORT group and 26 (IQR 24–28) in the CEADIL group, compared with 28 (IQR 26-28) in the unexposed control group (<i>p</i> &lt; 0.001). The ORT and the CEADIL group had higher odds for a MOS-R total score ≤ 24, a higher frequency of aberrant fidgety movements, reduced or absent age-adequate movement repertoire, abnormal observed postural patterns, and abnormal movement character, compared with the unexposed control group. The AIMS total score was 8.0 (IQR 7.0-11.5) in the ORT group and 9.0 (IQR 8.0-10.0) in the CEADIL group, compared with 11.8 (IQR 11.0-13.0) in the unexposed control group (<i>p</i> &lt; 0.001).</p> Conclusions <p>Similar to the CEADIL group, the ORT group had reduced quality of early motor behaviour compared with the control group. Hence, ORT-exposed infants may be at risk for neurodevelopmental impairment.</p> Trial registration <p>Not applicable.</p>

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Early motor behaviour in infants born to mothers in opioid replacement therapy during pregnancy: a prospective cohort study

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  • 发表日期：

    2026年7月31日

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  • Bodil B. Singstad,
  • Merete Brandal,
  • Vibeke S. Aulie,
  • Tordis Ustad,
  • Lars Adde,
  • Toril Fjørtoft,
  • Kari Anne I. Evensen

摘要

Background

There is a strong recommendation for opioid replacement therapy (ORT) in pregnant women dependent on opioids. Using drugs and alcohol in pregnancy is a well-documented risk factor for later neurodevelopmental impairment, and the infants have reduced quality of their early motor behaviour at the age of 3–4 months corrected age (CA). Growing evidence indicates that ORT exposure in utero has negative long-term effects on the child but whether ORT-exposed infants have reduced quality of early motor behaviour has never been studied. The primary aim of this study was to examine early motor behaviour at 3–4 months CA in infants born to mothers in ORT during pregnancy, infants exposed to alcohol and/or drugs and unexposed infants. Secondary, we aimed to estimate odds for reduced motor behaviour in the three groups.

Methods

In this prospective cohort study, Children Exposed to Alcohol and/or Drugs in Intrauterine Life (CEADIL), we used cross-sectional data to compare a group of infants exposed to ORT during pregnancy (ORT group, n = 15), a group of infants exposed to alcohol and/or drugs during pregnancy (CEADIL group, n = 99) and a group of healthy unexposed infants (control group, n = 105). Outcome measures were Motor Optimality Score-Revised (MOS-R) and the Alberta Infant Motor Scale (AIMS) at 3–4 months CA.

Results

The median MOS-R score was 26 (IQR 22-28) in the ORT group and 26 (IQR 24–28) in the CEADIL group, compared with 28 (IQR 26-28) in the unexposed control group (p < 0.001). The ORT and the CEADIL group had higher odds for a MOS-R total score ≤ 24, a higher frequency of aberrant fidgety movements, reduced or absent age-adequate movement repertoire, abnormal observed postural patterns, and abnormal movement character, compared with the unexposed control group. The AIMS total score was 8.0 (IQR 7.0-11.5) in the ORT group and 9.0 (IQR 8.0-10.0) in the CEADIL group, compared with 11.8 (IQR 11.0-13.0) in the unexposed control group (p < 0.001).

Conclusions

Similar to the CEADIL group, the ORT group had reduced quality of early motor behaviour compared with the control group. Hence, ORT-exposed infants may be at risk for neurodevelopmental impairment.

Trial registration

Not applicable.