title: Do maternal opioids reduce neonatal regional brain volumes? A pilot study.
abstract: OBJECTIVE
  A substantial number of children exposed to gestational opioids have neurodevelopmental, behavioral and cognitive problems. Opioids are not neuroteratogens but whether they affect the developing brain in more subtle ways (for example, volume loss) is unclear. We aimed to determine the feasibility of using magnetic resonance imaging (MRI) to assess volumetric changes in healthy opioid-exposed infants.
  
  
  METHODS
  Observational pilot cohort study conducted in two maternity hospitals in New South Wales, Australia. Maternal history and neonatal urine and meconium screens were obtained to confirm drug exposure. Volumetric analysis of MRI scans was performed with the ITK-snap program.
  
  
  RESULTS
  Scans for 16 infants (mean (s.d.) gestational age: 40.9 (1.5) weeks, birth weight: 3022.5 (476.6) g, head circumference (HC): 33.7 (1.5 cm)) were analyzed. Six (37.5%) infants had HC <25th percentile. Fourteen mothers used methadone, four used buprenorphine and 11 used more than one opioid (including heroin, seven). All scans were structurally normal whole brain volumes (357.4 (63.8)) and basal ganglia (14.5 (3.5)) ml were significantly smaller than population means (425.4 (4.8), 17.1 (4.4) ml, respectively) but lateral ventricular volumes (3.5 (1.8) ml) were larger than population values (2.1(1.5)) ml.
  
  
  CONCLUSIONS
  Our pilot study suggests that brain volumes of opioid-exposed babies may be smaller than population means and that specific regions, for example, basal ganglia, that are involved in neurotransmission, may be particularly affected. Larger studies including correlation with neurodevelopmental outcomes are warranted to substantiate this finding.
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia.
authors.forename: Q
authors.initials: Q
authors.lastname: Yuan
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Rubic
authors.affiliation: School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Seah
authors.affiliation: Neuroscience Research Australia, University of New South Wales, Randwick, NSW, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Rae
authors.affiliation: Graduate School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia.
authors.forename: I M R
authors.initials: IM
authors.lastname: Wright
authors.affiliation: Department of Pediatrics, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Kaltenbach
authors.affiliation: 1] School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia [2] Department of Paediatrics, Sydney Children's Hospital, Randwick, NSW, Australia.
authors.forename: J M
authors.initials: JM
authors.lastname: Feller
authors.affiliation: 1] Department of Neonatology, Centenary Hospital for Women and Children, Canberra, ACT, Australia [2] School of Clinical Medicine, Australian National University, Woden, ACT, Australia.
authors.forename: M E
authors.initials: ME
authors.lastname: Abdel-Latif
authors.affiliation: Department of Radiology, The Wollongong Hospital, Wollongong, NSW, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Chu
authors.affiliation: 1] School of Women's and Children's Health, University of New South Wales, Randwick, NSW, Australia [2] Department of Newborn Care, Royal Hospital for Women, Randwick, NSW, Australia.
authors.forename: J L
authors.initials: JL
authors.lastname: Oei
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects; D009293:Opioid-Related Disorders / Q000209:etiology / Q000473:pathology*; D009929:Organ Size; D010865:Pilot Projects; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000473:pathology*; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid