Study links prenatal opioid exposure to long-term challenges in children’s vision and behaviour
Published: 21 July 2026
Children exposed to opioids before birth may face increased risks of difficulties with vision, attention, behaviour and learning during their school years, according to a new study
Children exposed to opioids before birth may face increased risks of difficulties with vision, attention, behaviour and learning during their school years, according to a new study.
The research – led by the University of Glasgow in collaboration with the University of Dundee and published in Addiction – highlights the need for ongoing support for children exposed to opioids in the womb.
The study, a systematic review which looked at findings from the past decade, provide the most comprehensive assessment to date of how prenatal opioid exposure affects children aged five to 18 years.
By analysing 27 research papers involving more than 31,000 children exposed to opioids, alongside over 5.4 million unexposed children across 10 countries, the researchers found consistent evidence linking prenatal opioid exposure with: poorer visual outcomes, increased hyperactivity and attention difficulties (including a higher likelihood of Attention Deficit Hyperactivity Disorder) and lower cognitive performance.
The vision issues found in children included including higher rates of conditions such as strabismus (eye misalignment), nystagmus (involuntary eye movement), and reduced visual acuity; and cognitive issues included differences in memory, verbal IQ, and educational attainment.
The review also found emerging evidence of widening educational gaps over time, with some studies showing children exposed to opioids were twice as likely to fall below expected standards in literacy and numeracy by early adolescence.
Findings on physical health, brain development and emotional wellbeing were less conclusive, highlighting the need for further studies. 'However, researchers stress that pregnant women shouldn't make any changes to taking prescribed opioids without consulting their doctor.'
Dr Louise Marryat, LKAS Senior Research Fellow at the University’s School of Health and Wellbeing, said: “While we cannot say that prenatal opioid exposure directly causes these outcomes – and we have limited data on factors such as dosage, timing, and type of opioid exposure – the consistency of findings, particularly around vision, attention and learning, suggests that these children may face increased developmental challenges as they grow older.
“Families affected by opioid use face complex challenges, and policy interventions that prioritise family-centred, supportive approaches can improve outcomes for these children, with joined-up support across health, education and social care to ensure children and families receive the help they need long term.
“The study also highlights the need for long-term developmental monitoring, as well as improved awareness of vision and neurodevelopmental needs in clinicians, where early identification of attention and learning difficulties would enable timely support.
“Going forward, further research is needed to identify outcomes in adolescence.”
Alison McFadden, Professor of Mother and Infant Public Health at the University of Dundee’s Faculty of Health, said: "This important study highlights some of the long-term poor outcomes experienced by children who experienced prenatal opioid exposure. Further research is needed to understand the full range of effects, especially for children over 12 years of age."
The study included research from Europe, North America, Australasia, and Asia.
Exposure measures included illicit opioid use, medication for opioid use disorder (such as methadone and buprenorphine), and neonatal withdrawal diagnoses
The study, ‘Prenatal opioid exposure, and health, social, and educational outcomes for school-aged children: a systematic review,’ is published in Addiction. The work was funded by a UKRI Future Leaders Fellowship.
Enquiries: ali.howard@glasgow.ac.uk or elizabeth.mcmeekin@glasgow.ac.uk
First published: 21 July 2026