EVIDENCE BY SYMPTOM:
A RESEARCH HUB
Is there proof that prenatal opioid exposure causes the challenges faced by Generation O? Yes—there is!
While more research is needed and actively underway, existing peer-reviewed studies already highlight the links between prenatal opioid exposure and the developmental, behavioral, and medical challenges many of these children experience. This hub organizes the latest scientific evidence by symptom, making it easier to understand the connections and advocate for the right support.
Explore the research below and see what the science says.
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Fong, J. et al. (2024). Developmental Outcomes after Opioid Exposure in the Fetus and Neonate, Neoreviews, 25 (6), e325–e337.
Yun, H et al. (2024). A Prospective Multi-Institutional Study Comparing the Brain Development in the Third Trimester between Opioid-Exposed and Nonexposed Fetuses Using Advanced Fetal MR Imaging Techniques, American Journal of Neuroradiology, 45 (2), 218-223.
Bick, J. et al. (2024). Prenatal Risk and Later Intellectual and Developmental Disabilities. In: Valdovinos, M.G. (eds) Intellectual and Developmental Disabilities. Contemporary Clinical Neuroscience. Springer, Cham.
Vasan, V. et al. (2021). Neonatal opioid exposure: public health crisis and novel neuroinflammatory disease, Neural Regeneration Research,
READ: 16(3), 430-432. https://doi.org/10.4103/1673-5374.293136.
Levine, T.A. et al (2021). Prenatal methadone exposure and child developmental outcomes in 2-year-old children, Dev Med Child Neurol, 63,
Rubenstein, E. et al. (2019). Brief Report: Maternal Opioid Prescription from Preconception Through Pregnancy and the Odds of Autism Spectrum Disorder and Autism Features in Children, J Autism Dev Disord, 49, 376–382.
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Cifuentes, E. et al. (2025). Risk of Congenital Ocular Anomaly After Prenatal Exposure to Medications: A EUROmediCAT Study, Birth Defects Research, 117, e2435.
Hamilton, R. et al. (2024). Impaired vision in children prenatally exposed to methadone: an observational cohort study, Eye (Lond), 38(1), 118-126.
READ: https://doi.org/10.1038/s41433-023-02644-3.
Adegboyega, O. et al. (2024). DNA methylation patterns in umbilical cord blood from infants of methadone maintained opioid dependent mothers, Sci Rep, 14.
READ: https://doi.org/10.1038/s41598-024-66899-w.
Aslaksen, A.K. et al. (2024). Visual function in Norwegian children aged 5–13 years with prenatal exposure to opioid maintenance therapy: A case–control study, Acta Ophthalmologica, 102, 409–420.
READ: https://doi.org/10.1111/aos.15764.
Merhar, S.L. et al. (2021). Effects of prenatal opioid exposure on functional networks in infancy, Developmental Cognitive Neuroscience, Vol 51,
READ: https://doi.org/10.1016/j.dcn.2021.100996.
Mactier, H. & Hamilton, R. (2020). Prenatal opioid exposure – Increasing evidence of harm, Early Human Development, Vol 150,
McGlone, L. et al. (2013). Neonatal Visual Evoked Potentials in Infants Born to Mothers Prescribed Methadone, Pediatrics, 131(3), e857–e863.
READ: https://doi.org/10.1542/peds.2012-2113.
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Finnegan, L.P. & Bada, H.S. (2024). Editorial: Effects of perinatal opioid exposure—volume II, Front. Pediatr., Vol 12,
Kang, J. et al. (2023). Prenatal opioid exposure and subsequent risk of neuropsychiatric disorders in children: nationwide birth cohort study in South Korea, BMJ, 385,
Spowart, K.M. et al. (2023). Executive functioning, behavioural, emotional, and cognitive difficulties in school-aged children prenatally exposed to methadone, Front. Pediatr.,
Smith, B. L. et al. (2022). Perinatal Morphine Exposure Leads to Sex-Dependent Executive Function Deficits and Microglial Changes in Mice, eNeuro, 9(5),
Levine, T.A. & Woodward, L.J. (2017). Early inhibitory control and working memory abilities of children prenatally exposed to methadone, Early Human Development, Volume 116, Pages 68-75.
Nygaard, E. et al. (2016). Behavior and Attention Problems in Eight-Year-Old Children with Prenatal Opiate and Poly-Substance Exposure: A Longitudinal Study, PLoS One, 11(6), e0158054.
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Wiley, K. et al. (2025). A Preliminary Investigation of Associations Between Traumatic Events Experienced During Pregnancy and Salivary Diurnal Cortisol Levels of Brazilian Adolescent Mothers and Infants, American Journal of Human Biology, 37.2.
Xu, J.H. et al. (2025). Maternal Perception of Infant Sleep and Bonding in Opioid Use Disorder, Journal of Addiction Medicine, 19(1), p 83-88.
Lust, C. et al. (2024). An Amplitude-Integrated EEG Evaluation of Neonatal Opioid Withdrawal Syndrome, Am J Perinatol, 41(S 01), e290-e297.
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Conradt, E. et al. (2025). Evidence for neurobehavioral risk phenotypes at birth, Pediatr Res, 97, 99–106.
Finnegan, L.P. & Bada, H.S. (2024). Editorial: Effects of perinatal opioid exposure—volume II, Front. Pediatr., Vol 12,
Adegboyega, O. et al. (2024). DNA methylation patterns in umbilical cord blood from infants of methadone maintained opioid dependent mothers, Sci Rep, 14.
Spowart, K.M. et al. (2023). Executive functioning, behavioural, emotional, and cognitive difficulties in school-aged children prenatally exposed to methadone, Front. Pediatr.,
Benninger, K.L. et al. (2023). Neonatal opioid withdrawal syndrome: an update on developmental outcomes, Clin Perinatol, 50(1), 17-29.
Vishnubhotla, R.V. (2022). Brain structural connections in neonates with prenatal opioid exposure, Frontiers in Neuroscience, Vol 15,
Radhakrishnan, R. et al. (2021). Resting state functional MRI in infants with prenatal opioid exposure—a pilot study, Neuroradiology, 63, 585–591.
Sandoval-Sierra, J.V. et al. (2020). Effect of short-term prescription opioids on DNA methylation of the OPRM1 promoter, Clin Epigenet, 12, 76.
READ: https://doi.org/10.1186/s13148-020-00868-8.
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Gaither, J.R. et al. (2024). Hospital Readmissions Among Infants With Neonatal Opioid Withdrawal Syndrome, JAMA Netw Open, 7(9).
Nagy, S. et al. (2024). Oral Feeding Outcomes in Infants Born With Neonatal Abstinence Syndrome, The Journal of Perinatal & Neonatal Nursing, 38(3), 250-255.
Abu, Y.F. et al. (2023). Opioid-induced dysbiosis of maternal gut microbiota during gestation alters offspring gut microbiota and pain sensitivity, Gut Microbes, 16(1).
Mensah, N.A. et al. (2023). Risk of Feeding Problems Among Infants With Neonatal Abstinence Syndrome: A Retrospective Cohort Study, Advances in Neonatal Care, 23(3), 254-263.
Nelson, R. (2022). Changes in infant microbiome linked to prenatal opioids,
The Lancet Microbe, Volume 3, Issue 11, e812.Lyu Z. et al. (2022). Long-Term Effects of Developmental Exposure to Oxycodone on Gut Microbiota and Relationship to Adult Behaviors and Metabolism, mSystems, 7.
Rueda-Ruzafa, L. et al. (2020). Opioid system influences gut-brain axis: Dysbiosis and related alterations, Pharmacological Research, Vol 159,
Maguire, D. & Gröer, M. (2016). Neonatal abstinence syndrome and the gastrointestinal tract, Medical Hypotheses, Vol 97, 11-15.
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Wilkinson, A. et al. (2023). Developmental implications of prenatal opioid exposure among school-aged children: a mixed methods and community-initiated analysis, BMC Public Health, 23, 1815.
Hartwell, M.L. et al. (2020). Association of Prenatal Opioid Exposure With Precentral Gyrus Volume in Children, JAMA Pediatr, 174(9), 893–896.
Benninger, K.L. et al. (2020). Prenatal Exposures Are Associated With Worse Neurodevelopmental Outcomes in Infants With Neonatal Opioid Withdrawal Syndrome, Frontiers in Pediatrics, Vol 8.
Miller, J.M. (2020). The Effects of Neonatal Abstinence Syndrome on Language Delay from Birth to 10 Years, Journal of Pediatric Nursing, Vol 51, 67-74.
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Uebel, H. et al. (2024). School performance in children with prenatal drug exposure and out-of-home care in NSW, Australia: a retrospective population-based cohort study, The Lancet Child & Adolescent Health, Vol 8 (7), 500-509.
Lee, S.J. et al. (2019). Educational achievement at age 9.5 years of children born to mothers maintained on methadone during pregnancy, PLOS One, 14(10).
Miller, J.S. (2019). The Long-term Effects of Neonatal Abstinence Syndrome on Neurodevelopmental Health Outcomes, PhD diss, University of Tennessee.
Fill, M.A. et al. (2018). Educational Disabilities Among Children Born With Neonatal Abstinence Syndrome, Pediatrics, 142 (3).
Oei, J.L. et al. (2017). Neonatal Abstinence Syndrome and High School Performance, Pediatrics, 139 (2).
READ: https:/doi.org/10.1542/peds.2016-2651.
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Balalian, A.A. et al (2023). Prenatal exposure to opioids and neurodevelopment in infancy and childhood: A systematic review, Front Pediatr, 11.
Towers, C. et al. (2021). Torticollis in infants with neonatal abstinence syndrome, Journal of Perinatology, 41, 1-4.
Hartwell, M.L. et al. (2020). Association of Prenatal Opioid Exposure With Precentral Gyrus Volume in Children, JAMA Pediatr, 174(9), 893–896.
Yeoh, S.L. et al. (2019). Cognitive and Motor Outcomes of Children With Prenatal Opioid Exposure: A Systematic Review and Meta-analysis, JAMA Netw Open, 2(7).
McAllister, J.M. et al. (2018). Torticollis in Infants with a History of Neonatal Abstinence Syndrome, The Journal of Pediatrics, Vol 196, 305-308.
READ: https://doi.org/10.1016/j.jpeds.2017.12.009. PMID: 29395169.
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Jansson, L.M. & Patrick, S.W. (2019). Neonatal Abstinence Syndrome, Pediatric Clinics of North America, Vol 66 (2), 353-367.
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Wilkinson, A. et al (2023). Developmental implications of prenatal opioid exposure among school-aged children: a mixed methods and community-initiated analysis, BMC Public Health, 23, 1815.