106 - Ultrasound evaluation of brain parenchyma in preterm infants with prenatal opioid exposure

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 106
Publication Number: 106.336

Eileen Howard, Boston University School of Medicine, Boston, MA, United States; Bindu N. Setty, BU, Lexington, MA, United States; Chad W. Farris, Boston University School of Medicine, Boston, MA, United States; Elisha Wachman, Boston Medical Center, Boston, MA, United States; Joel Agarwal, Boston University School of Public Health, Boston, MA, United States; Ilse Castro-Aragon, Boston Medical Center, Chestnut Hill, MA, United States; Patrick Tivnan, Boston Children's Hospital, Boston, MA, United States

Presenting Author(s)

Eileen Howard, MSc (she/her/hers)

Medical Student
Boston University School of Medicine
Boston, Massachusetts, United States

Background: Antenatal exposure to opioids is reported to adversely affect fetal brain development, primarily the developing oligodendrocyte and the processes of myelination, connectivity between parts of the brain, and the size of multiple brain regions. Previous studies have utilized magnetic resonance imaging (MRI) to examine the size of the brain parenchyma in infants with antenatal opioid-exposure usually at a later postnatal age when it is more feasible to undergo the procedure. Head ultrasound (HUS) has the potential to be a complementary less resource intensive exam to assess brain parenchyma in opioid exposed infants.

Objective: To evaluate whether preterm infants with known prenatal opioid exposure have differences in the brain size as measured on postnatal HUS in comparison to matched non-opioid exposed preterm infants.

Design/Methods: Preterm infants born < 34 weeks gestation with known prenatal opioid exposure and a cohort of matched non-exposed infants with HUS during the first week of life were examined retrospectively. Fifteen standardized brain measurements were made on these HUS with each HUS being reviewed independently twice by a group of three radiologists (Figure 1). These measurements were then compared between the opioid and non-exposed cohorts.

Results:

Demographics of the opioid and non-exposed cohorts demonstrated differences in GA between the groups (p< 0.001), as well as differences in birth weight (p=0.002) and total length of hospital stay consistent with GA differences (Table 1). Overall measurements were smaller for brain parenchyma in the opioid-exposed versus the non-exposed infants, although the differences were small. Specifically, brain volumes were smaller in the right ventricular index [β=-0.18 mm (95% CI -0.28, -0.07)], left ventricular index [β=-0.04 mm (95% CI -0.08, -0.01)], left basal ganglia insula index [β=-0.08 mm (95% CI -0.13, -0.04)], right basal ganglia insula index [β=-0.10 mm (95% CI -0.14, -0.06)], corpus callosum fastigium length index [β=-0.16 mm (95% CI -0.23, -0.08)], intracranial height index [β=-0.31 mm (95% CI -0.42, -0.21)], and transcerebellar regions [β=-0.13 (95% CI -0.22, -0.04)] (Table 2).

Conclusion(s): Preterm infants with prenatal opioid exposure have smaller brain sizes compared to non-exposed infants as demonstrated by head ultrasound, albeit the size differences are small. Head ultrasound can be used as a complementary exam to MRI to detect these findings and allowed for detection of brain growth differences earlier than have been previously documented by postnatal MRI.
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