Treating pregnant women with opioid use disorder can help minimize opioid-related brain abnormalities in their newborns.
Led by scientists at Cedars-Sinai, this is the first study to report evidence validating the benefits of using medication for opioid use disorder in pregnancy. Brain imaging revealed significant improvements in brain function after treatment. The results have been published in the peer-reviewed journal JNeurosci.
“We are in a national opioid crisis, so it is urgent that we better understand how opioid exposure in pregnant women affects their children,” said study lead author Wei Gao, PhD, director of neuroimaging research at Biomedical Imaging Research. Institute at Cedars-Sinai and Professor of Biomedical Sciences. “Using imaging techniques can help us identify risks as early as possible so that we can hopefully intervene and minimize potential negative impacts on the developing fetal brain.”
Prenatal exposure to opioids and other drugs is a serious public health problem. The number of pregnant women using opioids more than quadrupled in the United States between 1999 and 2014. Exposure to opioids can alter or impact early brain growth, which can lead to a myriad of problems affecting skills socio-emotional, cognition and behavior.
Despite numerous studies of prenatal opioid exposure, little is known about the neural mechanisms that underlie the benefits of the drugs—buprenorphine and methadone, among others—that are used to stabilize the levels of opioids at which the fetus is exposed in the womb.
To better understand how this class of drugs affects the developing brain and the value of maternal treatments, Gao and his team used advanced resting-state functional MRI imaging to compare the brains of newborns who were exposed prenatally on either or both drugs with those exposed to opioids, but no drugs.
This emerging technique, resting-state fMRI, allows the research team to non-invasively examine the functional organization of the brain and see how different parts of the brain communicate.
“The data from the scans is in a time series of activity from each area of the brain,” said Janelle Liu, PhD, postdoctoral researcher at Cedars-Sinai’s Gao Laboratory and first author of the study. “We are able to use this data to compare series between the two brain areas to see how synchronized their activities are.”
After examining 109 newborn babies, the team found significant differences in the brains of those who were exposed to opioids before birth compared to those who weren’t exposed. There were changes in functional connectivity in brain regions that involved reward processing in newborns exposed to opioids.
For babies who were exposed to opioids, but with treatment, the differences partially or completely normalized compared to a brain not exposed to opioids.
“Our study shows that a baby’s brain can directly benefit from this treatment,” Gao said. “We hope this evidence will help promote drug uptake among affected pregnant women for better developmental outcomes,” Gao said.
In the future, Gao hopes to consider a more comprehensive intervention strategy by combining drugs with environmental factors to improve outcomes. Gao also directs the Cedars-Sinai site of the HEALthy Brain and Child Development (HBCD) study, which aims to delineate both typical brain and behavioral growth trajectories and how biological and environmental exposures, including opioids , marijuana, alcohol and tobacco, affect the development and overall health of children in a large national sample.
Funding: The research reported in this publication was supported by grants from the National Institutes of Health (R01DA042988, R01DA043678, R34DA050255) and the Cedars-Sinai Precision Medicine Initiative Award.