UK has $3 million grant to study impact of mothers’ opioid use on babies; Ky. 3rd in rate of babies with opioid-withdrawal syndrome

By Lindsay Travis, University of Kentucky/Kentucky Health News

A team of researchers at the University of Kentucky is working to better understand the impact of opioid-use disorder on mothers and babies.

Every 24 minutes in the United States, a baby is born with neonatal opioid withdrawal syndrome (NOWS) after being exposed via  a mother with opioid-use disorder.

In Kentucky, about 2 percent of babies born in 2020 had symptoms of NOWS — the third-highest rate in the U.S. In Appalachia Kentucky, that frequency increases to 7.7 percent — 77 of every 1,000 babies.

Early delivery can complicate pregnancies with opioid-use disorder and give children an increased risk of impaired neural development, including cognitive, motor, social and emotional abilities.

UK’s research team wants to understand how inflammation and dysregulation in the placenta caused by opioid use are linked to negative cognitive consequences in the baby.

The study titled “POPI: Placenta, Opioids and Perinatal Implications” is funded by a $3 million grant from the National Institute on Drug Abuse, part of the National Institutes of Health. Additional funding is possible, pending progress with the research.

“This study is going to have a tremendous impact on Kentuckians, many of whom know first-hand the profound devastation opioid use has on the overall health of the commonwealth,” said Ilhem Messaoudi, chair of the Department of Microbiology, Immunology and Molecular Genetics in the UK College of Medicine and one of the principal investigators on the grant.

“NIDA specifically called for research on the placenta-brain axis — the idea that what happens during pregnancy and the placenta’s health will have long-term ramifications on the offspring, including brain development,” said Messaoudi. “The team assembled to find answers for our smallest Kentuckians all bring a variety of expertise to this study including to maternal-fetal medicine, pathology, neuroscience and neonatology.”

Pregnant women who seek care at UK HealthCare’s Perinatal Assistance and Treatment Home (PATHways) program will be eligible to enroll in the study. PATHways, a comprehensive treatment program, is designed to help pregnant and postpartum mothers who are living with substance use disorders.

“Kentucky has one of the highest maternal mortality rates in the country combined with a high rate of opioid use disorder. PATHways provides us a unique opportunity to support pregnant mothers and invest in those lives through this kind of project that blends a variety of scientific specializations,” said Dr. John O’Brien, chief of the Division of Maternal-Fetal Medicine at UK HealthCare, a professor in the Department of Obstetrics and Gynecology in the College of Medicine and co-principal investigator on the grant.

As part of the study, researchers will collect ultrasound data, blood samples, the placenta and umbilical cord blood and conduct neurodevelopment assessment on babies for one year after birth. The data will help them determine the impact of maternal opioid use disorder on both the health of the placenta and the baby’s brain.

“In previous studies, using a rat model, we’ve learned maternal opioid use disorder increases inflammation in the brain and alters microglia — cells that are like the housekeepers of the brain,” Messaoudi said. “The alteration can affect the way the brain continues to develop.”

Investigators can measure that change in the brain through another type of immune cells found in the blood, called monocytes. The team will track neurobehavioral outcomes through a series of assessments in the newborn period and at age 3, 6 and 12 months.

O’Brien said, “Our hope is this research project will provide health-care professionals the knowledge and evidence necessary to improve the care of pregnant mothers with opioid use disorder, reduce risks and optimize neonatal outcomes.”

The study also includes researchers in the College of Medicine’s departments of Pediatrics and Pathology and Laboratory Medicine, as well as the Spinal Cord and Brain Injury Research Center and the Dr. Bing Zhang Department of Statistics in the College of Arts and Sciences.

If you or someone you know is pregnant and dealing with substance-use disorder, contact UK’s Polk-Dalton Clinic at 859-218-6165 to make an appointment for prenatal care.