P3.D076: Effect of Guardian Status of Patients Treated For Neonatal Opioid Withdrawal Syndrome On Developmental Questionnaire Response Rate

Background: Development of neonates who are treated for neonatal opioid withdrawal syndrome (NOWS) should be closely monitored because of the possible long-term effects of prenatal and postnatal exposure to opioids on the brain. However, multiple social factors may pose challenges in following up in a developmental clinic or even gathering responses from patients’ guardians to a developmental questionnaire over the phone. The objective of this study was to investigate if there is an association between guardian status of babies with NOWS and participation in answering the developmental questionnaire.

Methods: As part of a larger double-blinded randomized trial, neonates who were born between February 2018 and September 2023, diagnosed with NOWS, and with mothers who consented to participate were included in the study. The patients’ guardians were called when the baby was 6, 12 and 24 months to respond to the respective Ages and Stages Questionnaires (ASQ). Guardian contact information was collected from the patients’ charts. The questionnaire participation rate of the foster parents was compared with that of the biological or adoptive familial guardians using Fisher’s Exact test.

Results: Out of a total of 54 patients who qualified to participate in the study, 22 agreed to answer the ASQ (41%), 7 (32%) of them being foster parents and 15 (68%) of them being biological or adoptive familial guardians. Of the 32 participants who did not answer the ASQ (59%), 2 (6%) of them were foster parents and 30 (94%) of them were biological or adoptive familial guardians. Foster parents were statistically more likely to participate in the developmental questionnaire (p=0.02) compared to biological or adoptive familial guardians. Reasons for not answering the questionnaire included no longer consenting to the study, not picking up subsequent phone calls after attempting to reschedule, and not picking up the phone when called.

Conclusion: Foster parents were more consistent in following through with participation in the study regarding the development of their child with NOWS. We speculate that this may be because biological or adoptive familial guardians may not feel as comfortable with the medical system and are nervous answering questions regarding their child’s development. These findings warrant further studies in a larger population of infants with NOWS.