• Stephanie Welton, Brittany Blakelock, Sharen Madden, and Len Kelly.
• Researcher for the Anishinaabe Bimaadiziwin Research Program in Sioux Lookout, Ont.
• Can Fam Physician. 2019 Dec 1; 65 (12): e544-e551.

ObjectiveTo summarize information on the effects of opioid use in pregnancy on subsequent pediatric development and behaviour.Data SourcesSearches were performed in EMBASE, MEDLINE, and PsycINFO for peer-reviewed, English articles, including a manual search of their references, that were published between January 1, 2000, and May 1, 2018.Study SelectionOf the 543 articles reviewed, 19 relevant articles that focused on developmental effects of opioid exposure in utero were identified. Most of the studies provided level II evidence. One level I meta-analysis and 1 level III expert committee report were included.SynthesisThe literature was divided between documenting some level of impairment or normalization of early development deficits over time. Often no opioid effect was found once researchers controlled for socioenvironmental factors. The degree to which environmental factors, opioid exposure, or both affect pediatric development remains to be determined.ConclusionThe effect of maternal opioid use on pediatric development is unclear and the evidence is inconsistent. However, opioid exposure in pregnancy does define these children as a population at risk. They might experience developmental delays compared with their peers, yet remain within population norms in cognition, fine-motor skills, hand-eye coordination, executive function, and attention and impulsivity levels.Copyright© the College of Family Physicians of Canada.

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