712 - Head Ultrasound Findings In Infants Who Were Prenatally Exposed To Opioids

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 712
Publication Number: 712.234

Rishika P. Sakaria, University of Tennessee Health Science Center College of Medicine, Memphis, TN, United States; Divya Rana, University of Tennessee Health Science Center College of Medicine, Memphis, TN, United States; Aeshaa Pathak, University of Tennessee Health Science Center College of Medicine, memphis, TN, United States; Mimily Harsono, University of Tennessee Health Science Center College of Medicine, Memphis, TN, United States; Harris L. Cohen, Le Bonheur Children's Hospital, Memphis, TN, United States; Massroor Pourcyrous, UTHSC, Memphis, TN, United States

Presenting Author(s)

RS

Rishika P. Sakaria, MD, FAAP (she/her/hers)

Assistant Professor
University of Tennessee Health Science Center College of Medicine
The University of Tennessee Health Science Center
Memphis, Tennessee, United States

Background: The use of opioids during pregnancy has increased at an alarming rate during the last decade. One published study has described prenatal head ultrasound (HUS) findings in fetuses with in-utero opioid exposure, however, postnatal HUS findings in infants with prenatal opioid exposure have not yet been described.

Objective: The aim of this study was to evaluate the effects of prenatal exposure to opioids on HUS findings and to determine the need for routine HUS evaluation in infants exposed to prenatal opioids.

Design/Methods:

This is a prospective study performed at a level III NICU. Data were collected from an ongoing study on maternal substance use disorders (MSUD) and neonatal opioid withdrawal syndrome (NOWS) in the NICU. MSUD was confirmed with positive urine toxicology and/or umbilical cord toxicology testing. Infants and maternal demographics were recorded. At least one HUS was ordered on drug-exposed infants. Infants >32 weeks gestational age (GA) and >1500 g birthweight (BW) were included in this study. This group of infants do not require routine HUS for intraventricular hemorrhage determination per unit guidelines. HUS reports were collected.

Results:

From 2013 to 2020, 159 infants with BW >1500g and GA >32 weeks born to mothers with opioid use during pregnancy were admitted to our NICU. 9 infants did not have HUS performed due to attending discretion. Of the 150 infants with HUS, 24 (16%) infants (GA: 35-41.3 weeks; BW: 1700-3990g) had abnormal initial HUS. A summary of the initial HUS findings is presented in table 1. The median time at which the first HUS was performed was day of life (DOL) 5 (range: 1-35) for infants with abnormal HUS, and DOL 6 (range: 1-68) for infants with normal HUS. Five infants had repeat HUS after the initial abnormal HUS. Of these, in 1 infant, bilateral subependymal hemorrhages evolved into bilateral grade II intraventricular hemorrhages, and in another infant with echogenic periventricular white matter on the first HUS, repeat HUS showed bilateral subependymal hemorrhages. HUS findings in the remaining 3 infants remained the same on repeat examination.

Conclusion(s): A significant proportion of infants in this study had abnormal HUS findings. As infants >32 weeks GA and >1500g BW usually do not require HUS, there is limited data regarding those findings in this population. We cannot say with certainty that the findings noted in this study were due to prenatal opioid exposure. Further studies are required to correlate HUS findings with a specific drug of exposure, duration of exposure, polydrug use, umbilical cord drug concentration levels and clinical outcomes.