한빛사논문
- 조회298
Jiseung Kang, postdoctoral researcher1,2,3, Hyeon Jin Kim, senior data scientist and co-principal investigator4,5, Tae Kim, professor1, Hyeri Lee, doctoral student4,5, Minji Kim, doctoral student4,5, Seung Won Lee, professor6, Min Seo Kim, postdoctoral researcher7, Ai Koyanagi, professor8, Lee Smith, professor9, Guillaume Fond, professor10, Laurent Boyer, professor10, Masoud Rahmati, professor10,11,12, Guillermo F López Sánchez, professor13, Elena Dragioti, professor14,15, Samuele Cortese, professor16,17,18,19,20, Jae Il Shin, professor21,22, Dong Keon Yon, professor and principal investigator4,5,23, Marco Solmi, professor24,25,26,27
1Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, South Korea
2Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
3Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
4Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, South Korea
5Department of Regulatory Science, Kyung Hee University, Seoul, South Korea
6Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, South Korea
7Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
8Research and Development Unit, Parc Sanitari Sant Joan de Deu, Barcelona, Spain
9Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
10Research Centre on Health Services and Quality of Life, Aix Marseille University, Marseille, France
11Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
12Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
13Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
14Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
15Research Laboratory Psychology of Patients, Families and Health Professionals, Department of Nursing, School of Health Sciences, University of Ioannina, Ioannina, Greece
16Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
17Clinical and Experimental Sciences (Central Nervous System and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK
18Solent NHS Trust, Southampton, UK
19Hassenfeld Children’s Hospital at NYU Langone, New York University Child Study Center, New York City, NY, USA
20DiMePRe-J-Department of Precision and Regenerative Medicine-Jonic Area, University of Bari “Aldo Moro,” Bari, Italy
21Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
22Severance Underwood Meta-Research Center, Institute of Convergence Science, Yonsei University, Seoul, South Korea
23Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
24On Track: The Champlain First Episode Psychosis Program, Department of Mental Health, The Ottawa Hospital, ON, Canada
25Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, ON, Canada
26Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
27Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
JK and HJK contributed equally to this work as first authors.
JIS and DKY contributed equally.
Correspondence to: Dong Keon Yon
Abstract
Objective To investigate the potential association between prenatal opioid exposure and the risk of neuropsychiatric disorders in children.
Design Nationwide birth cohort study.
Setting From 1 January 2009 to 31 December 2020, birth cohort data of pregnant women in South Korea linked to their liveborn infants from the National Health Insurance Service of South Korea were collected.
Participants All 3 251 594 infants (paired mothers, n=2 369 322; age 32.1 years (standard deviation 4.2)) in South Korea from the start of 2010 to the end of 2017, with follow-up from the date of birth until the date of death or 31 December 2020, were included.
Main outcome measures Diagnosis of neuropsychiatric disorders in liveborn infants with mental and behaviour disorders (International Classification of Diseases 10th edition codes F00-99). Follow-up continued until the first diagnosis of neuropsychiatric disorder, 31 December 2020 (end of the study period), or the date of death, whichever occurred first. Eight cohorts were created: three cohorts (full unmatched, propensity score matched, and child screening cohorts) were formed, all of which were paired with sibling comparison cohorts, in addition to two more propensity score groups. Multiple subgroup analyses were performed.
Results Of the 3 128 571 infants included (from 2 299 664 mothers), we identified 2 912 559 (51.3% male, 48.7% female) infants with no prenatal opioid exposure and 216 012 (51.2% male, 48.8% female) infants with prenatal opioid exposure. The risk of neuropsychiatric disorders in the child with prenatal opioid exposure was 1.07 (95% confidence interval 1.05 to 1.10) for fully adjusted hazard ratio in the matched cohort, but no significant association was noted in the sibling comparison cohort (hazard ratio 1.00 (0.93 to 1.07)). Prenatal opioid exposure during the first trimester (1.11 (1.07 to 1.15)), higher opioid doses (1.15 (1.09 to 1.21)), and long term opioid use of 60 days or more (1.95 (1.24 to 3.06)) were associated with an increased risk of neuropsychiatric disorders in the child. Prenatal opioid exposure modestly increased the risk of severe neuropsychiatric disorders (1.30 (1.15 to 1.46)), mood disorders, attention deficit hyperactivity disorder, and intellectual disability in the child.
Conclusions Opioid use during pregnancy was not associated with a substantial increase in the risk of neuropsychiatric disorders in the offspring. A slightly increased risk of neuropsychiatric disorders was observed, but this should not be considered clinically meaningful given the observational nature of the study, and limited to high opioid dose, more than one opioid used, longer duration of exposure, opioid exposure during early pregnancy, and only to some neuropsychiatric disorders.
논문정보
- Research article
- 2024년 04월 (BRIC 등록일 2024-04-25)
- 국내(교신)+국외 연구진
- 의약학 > 의약학 기타
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