Pilot study of fetal brain development and morphometry in prenatal opioid exposure and smoking on fetal MRI - 11/01/21

Doi : 10.1016/j.neurad.2020.12.004

Rupa Radhakrishnan ^a,⁎ , Brandon P. Brown ^a, David M. Haas ^b, Yong Zang ^c, Christina Sparks ^d, Senthilkumar Sadhasivam ^d
^a Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, United States
^b Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, United States
^c Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, United States
^d Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, United States

^⁎Corresponding author at: Department of Radiology and Imaging Sciences, 705 Riley Hospital Drive, Indianapolis, IN 46202, United States.Department of Radiology and Imaging Sciences705 Riley Hospital DriveIndianapolisIN46202United States

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Graphical abstract

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Highlights

•	No macrostructural or maturational alterations on Fetal brain MRI in prenatal opioid exposure.
•	Significantly smaller vermian dimension on MRI in prenatal opioid exposed fetuses.
•	Differences in vermian dimensions persist after correcting for gestational age and maternal factors.

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Abstract

Purpose

The purpose of this study was to assess for any differences in brain maturation, structure and morphometry in fetuses exposed to opioids in utero, compared to non-opioid exposed fetuses on fetal MRI.

Methods

We performed a prospective study in pregnant women using opioids and healthy pregnant women without prenatal opioid use. We evaluated brain maturation, structure, and morphometry on second or third trimester fetal MRI and assessed group differences.

Results

28 pregnant women were enrolled, 12 with opioid exposure (average gestational age 33.67, range 28–39 w), 9 of whom also smoked, and 16 without opioid exposure (average gestational age 32.53, range 27–38 w). There was a significant difference in the anteroposterior diameter of the fetal cerebellar vermis in the opioid exposed fetuses compared to non-opioid exposed fetuses (p = 0.004). There were no significant differences in brain biparietal diameter, fronto-occipital diameter, transverse cerebellar diameter and anteroposterior dimension of the pons in opioid exposed fetuses compared to non-opioid exposed fetuses. There were no abnormalities in brain maturation and no major brain structural abnormalities in the opioid exposed fetuses.

Conclusion

Smaller fetal anteroposterior cerebellar vermian dimension was associated with in utero opioid exposure. There were no abnormalities in brain maturation or major structural abnormalities in fetuses exposed to opioids.

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Keywords : Prenatal Exposure, Brain development, Fetal Development, Fetal MRI, Opioid Use Disorder, Cerebellum