Preschool Language Development of Children Born to Women with an Opioid Use Disorder.
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ABSTRACT:
SUBMITTER: Kim HM
PROVIDER: S-EPMC8066299 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundPrevious studies indicate an increased risk for neuropsychological difficulties in young children prenatally exposed to opioids and polysubstances, but longitudinal information is scarce. The present longitudinal study investigated whether these waned, persisted, or increased over time.MethodsThe cognitive functioning of 72 children with prenatal opioid and polysubstance exposure and 58 children without any established prenatal risk was assessed at 1, 2, 3, 4½, and 8½ y.ResultsThe exposed boys had significantly and stably lower levels of cognitive functioning than the control group, whereas there were increasing differences over time for the girls. The exposed group had significantly lower IQ scores than the control group on Wechsler Intelligence Scale for Children--Revised at 8½ y after controlling for earlier cognitive abilities, and for children who were permanently placed in adoptive/foster homes before 1 y of age and whose mothers used heroin as their main drug during pregnancy (B = 17.04, 95% CI 8.69-25.38, P < 0.001).ConclusionWhile effects of prenatal substance exposure cannot be isolated, group effects on cognition rather increased than waned over time, even in adoptive/foster children with minimal postnatal risk.
| S-EPMC4539602 | biostudies-literature
Project description:OBJECTIVE:To evaluate temporal trends in medication-assisted treatment use among pregnant women with opioid use disorder. METHODS:We conducted a retrospective cohort study using Pennsylvania Medicaid administrative data. Trends in medication-assisted treatment use, opioid pharmacotherapy (methadone and buprenorphine) and behavioral health counselling, were calculated using pharmacy records and procedure codes. Cochrane-Armitage tests evaluated linear trends in characteristics of pregnant women using methadone compared with buprenorphine. RESULTS:In total, we evaluated 12,587 pregnancies among 10,741 women with opioid use disorder who had a live birth between 2009 and 2015. Across all years, 44.1% of pregnant women received no opioid pharmacotherapy, 27.1% used buprenorphine, and 28.8% methadone. Fewer than half of women had any behavioral health counseling during pregnancy. The adjusted prevalence of methadone use declined from 31.6% (95% CI 29.3-33.9%) in 2009 to 25.2% (95% CI 23.3-27.1%) in 2015, whereas the adjusted prevalence of buprenorphine use increased from 15.8% (95% CI 13.9-17.8%) to 30.9% (95% CI 28.8-33.0%). Greater increases in buprenorphine use were found in geographic regions with large metropolitan centers, such as the Southwest (plus 24.9%) and the Southeast (plus 12.0%), compared with largely rural regions, such as the New West (plus 5.2%). In 2015, the adjusted number of behavioral health counseling visits during pregnancy was 3.4 (95% CI 2.6-4.1) among women using buprenorphine, 4.0 (95% CI 3.3-4.7) among women who did not use pharmacotherapy, and 6.4 (95% CI 4.9-7.9) among women using methadone. CONCLUSION:Buprenorphine use among Medicaid-enrolled pregnant women with opioid use disorder increased significantly over time, with a small concurrent decline in methadone use. Behavioral health counseling use was low, but highest among women using methadone.
| S-EPMC6483844 | biostudies-literature
Project description:A revised form of MacArthur-Bates Communicative Development Inventory III (SCDI-III) was presented designed for Swedish speaking children aged 2 years 6 months-4 years 0 months with the objective to give a proxy measure of their language competence. The instrument contains a vocabulary checklist with 100 words, mainly predicates, from four areas; Food words, Body words, Mental words and Emotion words. Two sections assess the child's grammar skills and a final section appraises the child's metalinguistic awareness. Assessments from 1,134 parents are reported. Scales with adequate psychometric properties were formed for each section. Monthly median values and spread of score distributions are presented for each scale. Girls scored higher than boys on all scales. The revision, sampling procedures, demographic variables and issues of reliability and validity, are discussed. The general structure of the instrument can well be integrated in similar instruments designed for other languages and cultures.
| S-EPMC5574490 | biostudies-literature
Project description:Objective(s)To understand how contraception method use differed between women prescribed and not prescribed medications for opioid use disorder (MOUD) among commercially-insured and Medicaid-insured women.Study designIBM Watson Health MarketScan Commercial Claims and Encounters database and the Multi-State Medicaid database were used to calculate the (1) crude prevalence, and (2) adjusted odds ratios (adjusted for demographic characteristics) of using long-acting reversible or short-acting hormonal contraception methods or female sterilization compared with none of these methods (no method) in 2018 by MOUD status among women with OUD, aged 20 to 49 years, with continuous health insurance coverage through commercial insurance or Medicaid for ≥6 years. Claims data was used to define contraception use. Fisher exact test or χ2 test with a P-value ≤ 0.0001, based on the Holm-Bonferroni method, and 95% confidence intervals were used to determine statistically significant differences for prevalence estimates and adjusted odds ratios, respectively.ResultsOnly 41% of commercially-insured and Medicaid-insured women with OUD were prescribed MOUD. Medicaid-insured women with OUD prescribed MOUD had a significantly lower crude prevalence of using no method (71.1% vs 79.0%) and higher odds of using female sterilization (aOR, 1.33; 95% CI: 1.06-1.67 vs no method) than those not prescribed MOUD. Among commercially-insured women there were no differences in contraceptive use by MOUD status and 66% used no method.ConclusionsAmong women with ≥ 6 years of continuous insurance coverage, contraceptive use differed by MOUD status and insurance. Prescribing MOUD for women with OUD can be improved to ensure quality care.ImplicationsOnly two in five women with OUD had evidence of being prescribed MOUD, and majority did not use prescription contraception or female sterilization. Our findings support opportunities to improve prescribing for MOUD and integrate contraception and MOUD services to improve clinical care among women with OUD.
| S-EPMC9722562 | biostudies-literature
Project description:This SuperSeries is composed of the SubSeries listed below.
2022-05-31 | GSE198123 | GEO
Project description:ObjectiveThe opioid epidemic continues to evolve and impact all groups of people. Moreover, there are concerning trends among women. The aim of this article is to provide a review of opioid use disorder in women and the implications for treatment.MethodsA nonsystematic review of the literature as conducted to examine: (1) the epidemiology of opioid-related hospitalizations and deaths of women; (2) co-occurring pain, anxiety disorders, and trauma among women with opioid use disorder; (3) evidence for opioid agonist treatment of pregnant women with opioid use disorder; and (4) implications for treatment of women with opioid use disorder and next steps for research and practice.ResultsThe current opioid epidemic has produced important differences by sex and gender with increased rates of use and overdose deaths in women. Significant mental health concerns for women include co-occurring psychiatric disorders and suicide. Expanding medication treatment for perinatal opioid use disorder is crucial. While effective treatments exist for opioid use disorder, they are often not accessible, and a minority of patients are treated.ConclusionsThe end to the opioid epidemic will require innovative multi-systemic solutions. There are significant practice gaps in preventing rising death rates among women by opioid overdose, treating co-occurring psychiatric disorders and pain, and treating perinatal women with opioid use disorder and their infants. Research on sex and gender differences, and the intersection with race/ethnicity and US region, is critically needed and should include treatment implementation studies to achieve wider access for women to effective prevention, early intervention, and treatment.
| S-EPMC8639162 | biostudies-literature
Project description:BackgroundOpioid use disorder (OUD) is underdiagnosed in health system settings, limiting research on OUD using electronic health records (EHRs). Medical encounter notes can enrich structured EHR data with documented signs and symptoms of OUD and social risks and behaviors. To capture this information at scale, natural language processing (NLP) tools must be developed and evaluated. We developed and applied an annotation schema to deeply characterize OUD and related clinical, behavioral, and environmental factors, and automated the annotation schema using machine learning and deep learning-based approaches.MethodsUsing the MIMIC-III Critical Care Database, we queried hospital discharge summaries of patients with International Classification of Diseases (ICD-9) OUD diagnostic codes. We developed an annotation schema to characterize problematic opioid use, identify individuals with potential OUD, and provide psychosocial context. Two annotators reviewed discharge summaries from 100 patients. We randomly sampled patients with their associated annotated sentences and divided them into training (66 patients; 2,127 annotated sentences) and testing (29 patients; 1,149 annotated sentences) sets. We used the training set to generate features, employing three NLP algorithms/knowledge sources. We trained and tested prediction models for classification with a traditional machine learner (logistic regression) and deep learning approach (Autogluon based on ELECTRA's replaced token detection model). We applied a five-fold cross-validation approach to reduce bias in performance estimates.ResultsThe resulting annotation schema contained 32 classes. We achieved moderate inter-annotator agreement, with F1-scores across all classes increasing from 48 to 66%. Five classes had a sufficient number of annotations for automation; of these, we observed consistently high performance (F1-scores) across training and testing sets for drug screening (training: 91-96; testing: 91-94) and opioid type (training: 86-96; testing: 86-99). Performance dropped from training and to testing sets for other drug use (training: 52-65; testing: 40-48), pain management (training: 72-78; testing: 61-78) and psychiatric (training: 73-80; testing: 72). Autogluon achieved the highest performance.ConclusionThis pilot study demonstrated that rich information regarding problematic opioid use can be manually identified by annotators. However, more training samples and features would improve our ability to reliably identify less common classes from clinical text, including text from outpatient settings.
| S-EPMC9124945 | biostudies-literature
Project description:BackgroundThe postpartum year is a vulnerable period for women with opioid use disorder, with increased rates of fatal and nonfatal overdose; however, data on the continuation of medications for opioid use disorder on a population level are limited.ObjectiveThis study aimed to examine the effect of discontinuing methadone and buprenorphine in women with opioid use disorder in the year following delivery and determine the extent to which maternal and infant characteristics are associated with time to discontinuation of medications for opioid use disorder.Study designThis population-based retrospective cohort study used linked administrative data of 211,096 deliveries in Massachusetts between 2011 and 2014 to examine the adherence to medications for opioid use disorder. Individuals receiving medications for opioid use disorder after delivery were included in the study. Here, demographic, psychosocial, prenatal, and delivery characteristics are described. Kaplan-Meier survival analysis and Cox regression modeling were used to examine factors associated with medication discontinuation.ResultsA total of 2314 women who received medications for opioid use disorder at delivery were included in our study. Overall, 1484 women (64.1%) continued receiving medications for opioid use disorder for a full 12 months following delivery. The rate of continued medication use varied from 34% if women started on medications for opioid use disorder the month before delivery to 80% if the medications were used throughout pregnancy. Kaplan-Meier survival curves differed by maternal race and ethnicity (the 12-month continuation probability was .65 for White non-Hispanic women and .51 for non-White women; P<.001) and duration of use of prenatal medications for opioid use disorder (12-month continuation probability was .78 for women with full prenatal engagement and .60 and .44 for those receiving medications for opioid use disorder ≥5 months [but not throughout pregnancy] and ≤4 months prenatally, respectively; P<.001). In all multivariable models, duration of receipt of prenatal medications for opioid use disorder (≤4 months vs throughout pregnancy: adjusted hazard ratio, 3.26; 95% confidence interval, 2.72-3.91) and incarceration (incarceration during pregnancy or after delivery vs none: adjusted hazard ratio, 1.79; 95% confidence interval, 1.52-2.12) were most strongly associated with the discontinuation of medications for opioid use disorder.ConclusionAlmost two-thirds of women with opioid use disorder continued using medications for opioid use disorder for a full year after delivery; however, the rates of medication continuation varied significantly by race and ethnicity, degree of use of prenatal medications for opioid use disorder, and incarceration status. Prioritizing medication continuation across the perinatal continuum, enhancing sex-specific and family-friendly recovery supports, and expanding access to medications for opioid use disorder despite being incarcerated can help improve postpartum medication adherence.
| S-EPMC8492487 | biostudies-literature
Project description:PurposeThis study tested children's sensitivity to tense/agreement information in fronted auxiliaries during online comprehension of questions (e.g., Are the nice little dogs running?). Data from children with developmental language disorder (DLD) were compared to previously published data from typically developing (TD) children matched according to sentence comprehension test scores.MethodFifteen 5-year-old children with DLD and fifteen 3-year-old TD children participated in a looking-while-listening task. Children viewed pairs of pictures, 1 with a single agent and 1 with multiple agents, accompanied by a sentence with a fronted auxiliary (is + single agent or are + two agents) or a control sentence. Proportion looking to the target was measured.ResultsChildren with DLD did not show anticipatory looking based on the number information contained in the auxiliary (is or are) as the younger TD children had. Both groups showed significant increases in looking to the target upon hearing the subject noun (e.g., dogs).ConclusionsDespite the groups' similar sentence comprehension abilities and ability to accurately respond to the information provided by the subject noun, children with DLD did not show sensitivity to number information on the fronted auxiliary. This insensitivity is considered in light of these children's weaker command of tense/agreement forms in their speech. Specifically, we consider the possibility that failure to grasp the relation between the subject-verb sequence (e.g., dogs running) and preceding information (e.g., are) in questions in the input contributes to the protracted inconsistency in producing auxiliary forms in obligatory contexts by children with DLD.Supplemental materialhttps://doi.org/10.23641/asha.7283459.
| S-EPMC6440306 | biostudies-literature
Project description:Developmental language disorder (DLD), previously known as specific language impairment, is a neurodevelopmental disorder. It affects approximately 7% of school-age children. The affected children fail to develop normal speech and language skills. This is a major public health concern as it adversely impacts the communication, academic, and social skills of the affected individual. The human brain development is a complex process that involves the accurate orchestration of the expression of multiple genes. Precise temporal and spatial regulation of gene expression is essential for proper brain development. Epigenetic factors such as DNA methylation can modulate gene expression without altering the DNA sequence. They are, therefore, considered as key regulators of the expression of genes involved in neurodevelopment. In this study, we examined any altered DNA methylation between children affected with DLD and healthy control subjects. We looked into genome-wide methylation differences between the DLD and control groups using Infinium HumanMethylation850 (EPICarray). Twelve children with DLD and 12 healthy controls were recruited for the study. Five milliliters of peripheral blood samples were collected from the study subjects in EDTA vials. Genomic DNA (gDNA) was extracted from the blood samples using the standard salting out protocol. Five micrograms of each DNA at 50 ng/µl concentration were used for genome-wide methylation analysis. The gDNA samples were bisulfite-treated with EpiTect Bisulfite Kit. Further to this, the DNA samples were subjected to whole genome amplification and enzymatic fragmentation. Human Infinium Methylation EPIC BeadChip (Illumina), which covers more than 850,000 genome-wide methylation sites, was used for genome-wide methylation analysis. The DNA methylation profiles of each sample were visualized at the single-CpG level and for the genomic regions of interest.
2024-01-10 | E-MTAB-13583 | biostudies-arrayexpress