TOP 49 - Effects of Maternal Opioid Use on Offspring Gut Metabolomic Composition: A Pilot Study

Publication Number: 4752.TOP 49

Elisabeth Romero, Tufts University School of Medicine, Melrose, MA, United States; Marissa Chow, Floating Hospital for Children at Tufts Medical Center, Boston, MA, United States; Kiran Singh, Tufts Medical center, Boston, MA, United States; Ronnelle King, Floating Hospital for Children at Tufts Medical Center, Boston, MA, United States; Mario Cordova, Director of Neonatology at Lowell General Hospital, Boston, MA, United States; Meghan I. Short, Tufts University School of Medicine, Boston, MA, United States; Elizabeth Yen, Tufts Medicine Pediatrics-Boston Children's, Boston, MA, United States

Background: Opioids are associated with inflammation-related changes in gut microbial diversity and short-chain fatty acids (SCFA) levels that are critical for intestinal barriers, further propagating systemic and neuroinflammation. Such inflammation dysregulates neurotransmitter balance (e.g., dopamine), leading to aberrant reward signaling, altered feeding behaviors, and increased cardiometabolic risks. However, the effect of opioids on the gut-brain axis is not well studied in neonates.

Objective: To identify the inflammatory effects of maternal opioid use on offspring microbiome diversity and metabolomic composition. We hypothesize that opioid-exposed neonates have increased inflammation, decreased microbial α diversity, and shifts in species composition, which modulate anti-inflammatory and neuroprotective metabolite levels (e.g., butyrate, dopamine).

Design/Methods: In this IRB-approved, prospective observational study, stool samples from neonates ≥34 weeks GA with and without prenatal opioid exposure were collected within 24 hours after birth and before discharge to undergo metabolomic analyses (targeted and untargeted). Data were stratified by opioid exposure. Continuous data were analyzed using a Welch t-test, and categorical data using a Fisher's exact test. Significance was set at p< 0.05.

Preliminary Data: Demographic data of 17 non-exposed and 20 opioid-exposed neonates showed similar characteristics, except for greater cigarette smoking, length of stay, and use of formula feeding in the opioid-exposed cohort (p < 0.05, Table). α microbial diversity and species compositions did not differ significantly by opioid exposure. Neurotransmitter and SCFA analyses are ongoing and will be completed by January 2026.

Table 1. Demographic and Clinical Data


Table 2. Metabolites