Salivary Cortisol Levels Relate to Cognitive Performance in Children Prenatally Exposed to Methadone or Buprenorphine

Abstract

Opioid maintenance therapy (OMT) is generally recommended for pregnant opioid‐ dependent women. However, much is still unknown about the potential long‐term effects of prenatal methadone and buprenorphine exposure. This study explored the long‐term effects of prenatal methadone and buprenorphine exposure in a co‐ hort (n = 41) of children, aged 9–11 years, using the Wechsler Abbreviated Scale of Intelligence (WASI) to measure cognitive development and salivary cortisol samples to measure HPA‐axis activity. Prenatally exposed children scored significantly lower on all four subtests of WASI (vocabulary, similarities, block design, and matrix rea‐ soning), compared to a comparison group (all p < .05). No group differences were found for salivary cortisol levels or cortisol reactivity levels (all p > .05). Cortisol lev‐ els significantly predicted matrix reasoning scores for the OMT group, β = −65.58, t(20) = 15.70, p = .02. Findings suggest that prenatal exposure to methadone or buprenorphine does not have long‐term effects on children's HPA‐axis functioning. However, since children of women in OMT scored significantly lower on tasks of cognitive function, careful follow‐up throughout the school years and across adoles‐ cence is recommended.