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Children
Special Issues
Prenatal Substance Exposure: Historical Perspective, Current Research and Future Challenges
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Prenatal Substance Exposure: Historical Perspective, Current Research and Future Challenges

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: 5 January 2026 | Viewed by 547

Special Issue Editors

Dr. Thitinart Sithisarn

E-Mail Website
Guest Editor
College of Medicine, University of Kentucky, Lexington, KY 40536, USA
Interests: perinatal addiction; translational study and animal models; neurodevelopmental follow-up; neonatal physiologic measures
Prof. Dr. Henrietta S. Bada

E-Mail Website
Guest Editor
College of Medicine, University of Kentucky, Lexington, KY 40536, USA
Interests: newborn brain disorders; perinatal addiction; neurodevelopmental follow-up; neonatal physiologic measures

Special Issue Information

Dear Colleagues,

This Special Issue will provide an overview of the evolving understanding of prenatal substance exposure, including historical perspectives, current research, and future challenges. Initially, cases of morphine withdrawal in newborns led to a diagnosis of “congenital morphinism,” marked by high mortality rates. As substance use has diversified, recent research, driven by the opioid crisis, focuses on neonatal abstinence syndrome (NAS)/neonatal opioid withdrawal syndrome (NOWS). Although the extensive literature addresses assessment, treatment, and outcomes, there remains no consensus on optimal management practices. Variables such as co-occurring maternal health issues, social determinants, and poly-substance exposure—including alcohol, tobacco, and other drugs such as cocaine, amphetamines, benzodiazepine, cannabinoids, etc.—further complicate withdrawal manifestations and outcomes. This research collection broadens examination of the impact of both illicit and prescribed substances. Key controversies and research gaps will be highlighted, emphasizing the need for standardization in management and treatment approaches. This synthesis aims to guide practices that improve both short- and long-term outcomes for affected infants. In addition, translational and scientific approaches to determining the impacts of prenatal substance exposure on neurocircuitry development and outcomes are supported in this Special Issue.

Dr. Thitinart Sithisarn
Prof. Dr. Henrietta S. Bada
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neonatal abstinence syndrome
  • neonatal opioid withdrawal syndrome
  • prenatal substance exposure
  • opioids
  • cocaine
  • amphetamine
  • cannabinoids/cannabis
  • tobacco
  • benzodiazepine
  • neurodevelopmental outcomes

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Published Papers (2 papers)

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Research

15 pages, 495 KiB  
Article
Perceptions of Infant Cry Sounds Among Tobacco and Cannabis Using Mothers and Their Association with Tobacco and Cannabis Cravings
by Pamela Schuetze, Madison R. Kelm, Olivia Bell and Rina D. Eiden
Children 2025, 12(8), 1006; https://doi.org/10.3390/children12081006 (registering DOI) - 31 Jul 2025
Abstract
Background/Objectives: We examined maternal perceptions of infant cries as a mediator between maternal tobacco/cannabis use, psychological distress (depression/anger/hostility) and reported cravings for cigarettes and/or cannabis across two time points. Methods: A total of 96 substance-using mothers (35 tobacco-only and 61 tobacco/cannabis) [...] Read more.
Background/Objectives: We examined maternal perceptions of infant cries as a mediator between maternal tobacco/cannabis use, psychological distress (depression/anger/hostility) and reported cravings for cigarettes and/or cannabis across two time points. Methods: A total of 96 substance-using mothers (35 tobacco-only and 61 tobacco/cannabis) were recruited in pregnancy. Maternal substance use and psychological distress were measured when their children were school age (5–6 years, T1). At the middle childhood assessment (9–12 years, T2), mothers listened to a standardized set of newborn cries and, afterwards, rated their aversiveness, impact on negative affect, and their tobacco/cannabis cravings. Results: Higher levels of maternal depressive symptoms at T1 were associated with perceptions of cries as being more aversive at T2, which, in turn, were associated with increased cannabis cravings at T2. At T1, higher depressive symptoms predicted increased tobacco cravings and higher maternal anger/hostility predicted increased cannabis cravings. Conclusions: Results highlight the role that infant cries and psychological distress play in cravings among tobacco/cannabis-using mothers. Full article
(This article belongs to the Special Issue Prenatal Substance Exposure: Historical Perspective, Current Research and Future Challenges)
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12 pages, 361 KiB  
Article
Mothers with Concurrent Opioid and Cocaine Use and Neonatal Opioid Withdrawal Syndrome
by Divya Rana, Linda DeBaer and Massroor Pourcyrous
Children 2025, 12(7), 916; https://doi.org/10.3390/children12070916 - 11 Jul 2025
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Abstract
Background: Polysubstance use, particularly combining opioids with stimulants such as cocaine, is rising among individuals with substance use disorders. This practice aims to balance cocaine’s stimulant effects with opioids’ sedative effect, potentially decreasing adverse outcomes. We hypothesized that concurrent exposure to cocaine and [...] Read more.
Background: Polysubstance use, particularly combining opioids with stimulants such as cocaine, is rising among individuals with substance use disorders. This practice aims to balance cocaine’s stimulant effects with opioids’ sedative effect, potentially decreasing adverse outcomes. We hypothesized that concurrent exposure to cocaine and opioids would reduce the risk of neonatal opioid withdrawal syndrome (NOWS) compared to opioid use alone. Methods: This analysis draws from an ongoing prospective study of maternal substance use (SUD) at Regional One Health’s perinatal center in Memphis, TN, and included mothers and their infants born between 2018 and 2022. Maternal SUD was identified via screening questionnaires, urine toxicology, or umbilical cord tissue analysis. Participants were grouped into using (a) opioids with cocaine (OwC) and (b) opioids without cocaine (OwoC). Univariate and regression analyses were conducted to assess the risk of NOWS. Results: A total of 353 infants were born to 342 mothers, with 31% (110/353) of the infants born to women who used cocaine along with opioids. While maternal demographics were similar, the OwC group had significantly lower rates of prenatal care, chronic pain history, and MOUD enrollment (p = 0.03). Infants in the OwC group had significantly higher rates of NOWS (p < 0.01), longer hospital stays (p < 0.01), and 6.5 times greater odds of developing NOWS (p < 0.001). NOWS was associated with an average 15-day increase in the length of stay for term infants (95% CI: 11.2, 18.8; p < 0.001). Conclusions: Contrary to our hypothesis, our study highlights the significant impact of maternal cocaine use on the increased likelihood of NOWS and extended hospital stays for affected infants. Full article
(This article belongs to the Special Issue Prenatal Substance Exposure: Historical Perspective, Current Research and Future Challenges)
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