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 in mothers with opioid use disorder.

In Kentucky, roughly 20 of every 1,000 babies born in 2020 had symptoms of NOWS — the third-highest rate in the U.S. In Appalachia Kentucky, that frequency increases to 77 babies of every 1,000.

Early delivery can complicate pregnancies with opioid use disorder and children have an increased risk of neurodevelopment impairment including cognitive, motor, social and emotional abilities related to this exposure.

UK’s research team wants to understand how inflammation and dysregulation in the placenta from 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 (NIDA), part of the National Institutes of Health with additional funding pending progress with the research.

“This study is going to have a tremendous impact on Kentuckians, many of whom know firsthand the profound devastation opioid use has on the overall health of the Commonwealth,” said Ilhem Messaoudi, Ph.D., 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 persons 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 John O’Brien, M.D., 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. The alteration can affect the way the brain continues to develop,” said Messaoudi.

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.

“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,” said O’Brien.

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 the Polk-Dalton Clinic at 859-218-6165 to make an appointment for prenatal care.

Research reported in this publication was supported by the National Institute on Drug Abuse of the National Institutes of Health under Award Number R01DA059152. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.