Background: Maternal drug use during pregnancy can lead to various adverse effects in the newborn, including Neonatal opioid withdrawal syndrome (NOWS) which may affect up to 94% of infants exposed to opioids in utero.Therefore, there is a need to understand long-term outcomes of NOWS, such as asthma, in children exposed to drugs/substances in utero.

Methods: We analyzed cross-sectional parent/adolescent data (N = 11,876) from the Adolescent Brain and Cognitive Development Study. Participant data included adolescents aged 9-11 years (Male=52.2%) and parents aged 23-80 years (M=39.9; SD=6.8). Logistic regression analyses were estimated to determine the associations between mother substance use (marijuana, cocaine, morphine/heroin) behaviors (exposure) and adolescent asthma (outcome). Mothers’ substance use behaviors questions were contextualized as “before they knew they were pregnant” and “after they knew they were pregnant.”

Results: 17.3% of adolescents reported having an asthma attack within the last year of baseline assessment. When adjusting for adolescents’ gender, Hispanic origin, parent age, tobacco, alcohol, and prescription medication use, again only cocaine use after knowing of pregnancy was associated with asthma outcomes (OR=4.80,p<0.01) with other associations of similar magnitudes.

Discussion: Cocaine and heroine(opioid) are powerful drugs that can lead to dependency, overdose, and death. We found elevated results for both these drugs in a nationwide representative sample leading to asthma in children. These results suggest infants of mothers engaging in substance use may have altered immune reactivity that not only impacts the newborn period but persists into childhood leading to long-term outcomes such as asthma and other respiratory symptoms.