Educational achievement at age 9.5 years of children born to mothers maintained on methadone during pregnancy.

Pencapaian pendidikan pada usia 9,5 tahun pada anak-anak yang dilahirkan oleh ibu yang menjalani terapi rumatan metadon selama kehamilan.

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ID: 62538
2019
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Abstract
Recent research shows that preschool children born to opioid-dependent mothers are at increased risk for cognitive, psychomotor, attention, and social-emotional adjustment problems. But very little is known about their school-age functioning, particularly their educational achievement. This analysis examined the educational outcomes of a regional cohort of 100 prenatally methadone-exposed children who were prospectively studied from birth to age 9.5 years alongside a comparison group of 110 randomly identified non-exposed children born between 2003 and 2008. At age 9.5, as part of a comprehensive neurodevelopmental evaluation, children's teachers rated their achievement across the school curriculum, and children completed the Woodcock Johnson-III Tests of Achievement (WJ-III). Detailed information about the birth mother's social background, pregnancy substance use, and mental health was also collected during pregnancy/at term. Infant clinical data were collected after birth. Methadone-exposed children performed less well than non-exposed children across seven school curriculum areas rated by teachers (ps ≤.001), performed less well than non-exposed children on all reading and mathematics subtests of the WJ-III, and had higher rates of any educational delay on the WJ-III (57% vs. 15%), OR = 7.47 (3.71-15.02). Results were similar when children with severe intellectual impairment were excluded. After adjusting for confounding factors, methadone-exposed children had increased odds of educational delay, but this was only marginally significant (OR = 3.62, [1.01-13.01], p = .049). Maternal educational attainment level (OR = 0.69, [0.50-0.89], p = .006), and maternal benzodiazepine use during pregnancy (OR = 2.70 [1.03-7.12], p = .044) were also associated with later educational risk. Findings suggest that children born to opioid-dependent women enrolled in methadone maintenance are at high risk of educational delay by age 9.5 years. Children's academic difficulties appeared to reflect the effects of both adverse prenatal exposures and postnatal social risk.
Penelitian terkini menunjukkan bahwa anak-anak usia prasekolah yang lahir dari ibu yang mengalami ketergantungan opioid memiliki peningkatan risiko masalah penyesuaian kognitif, psikomotor, atensi, dan sosial-emosional. Namun, sangat sedikit yang diketahui mengenai keberfungsian mereka pada usia sekolah, khususnya pencapaian pendidikan mereka. Analisis ini meneliti luaran pendidikan dari sebuah kohor regional yang terdiri atas 100 anak yang terpapar metadon secara pranatal yang diteliti secara prospektif sejak lahir hingga usia 9,5 tahun, bersama dengan kelompok pembanding yang terdiri atas 110 anak tanpa paparan yang diidentifikasi secara acak yang lahir antara tahun 2003 dan 2008. Pada usia 9,5 tahun, sebagai bagian dari evaluasi neurodevelopmental yang komprehensif, guru menilai pencapaian anak-anak tersebut di seluruh kurikulum sekolah, dan anak-anak menyelesaikan tes *Woodcock Johnson-III Tests of Achievement* (WJ-III). Informasi terperinci mengenai latar belakang sosial ibu kandung, penggunaan zat selama kehamilan, dan kesehatan mental juga dikumpulkan selama kehamilan/saat aterm. Data klinis bayi dikumpulkan setelah kelahiran. Anak-anak yang terpapar metadon menunjukkan performa yang lebih rendah dibandingkan anak-anak yang tidak terpapar di tujuh bidang kurikulum sekolah yang dinilai oleh guru (p ≤ 0,001), menunjukkan performa yang lebih rendah dibandingkan anak-anak yang tidak terpapar pada seluruh subtes membaca dan matematika WJ-III, serta memiliki tingkat keterlambatan pendidikan yang lebih tinggi pada WJ-III (57% vs. 15%), OR = 7,47 (3,71–15,02). Hasil serupa diperoleh ketika anak-anak dengan gangguan intelektual berat dieksklusikan. Setelah mengontrol faktor-faktor perancu, anak-anak yang terpapar metadon memiliki peningkatan odds keterlambatan pendidikan, tetapi hal ini hanya signifikan secara marjinal (OR = 3,62, [1,01–13,01], p = 0,049). Tingkat pencapaian pendidikan ibu (OR = 0,69, [0,50–0,89], p = 0,006) dan penggunaan benzodiazepin oleh ibu selama kehamilan (OR = 2,70 [1,03–7,12], p = 0,044) juga berkaitan dengan risiko pendidikan di kemudian hari. Temuan ini mengindikasikan bahwa anak-anak yang lahir dari wanita dengan ketergantungan opioid yang terdaftar dalam program pemeliharaan metadon berisiko tinggi mengalami keterlambatan pendidikan pada usia 9,5 tahun. Kesulitan akademik anak-anak tampaknya mencerminkan efek gabungan dari paparan pranatal yang merugikan serta risiko sosial pascalahir.
Reference Key
lee2019educationalplos Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Lee, Samantha J;Woodward, Lianne J;Henderson, Jacqueline M T;
Journal PloS one
Year 2019
DOI
10.1371/journal.pone.0223685
URL
Keywords
reading disability writing english-language learners second language learners

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