Article Summary #10: Self-Regulation and Emotional Reactivity in Infants with Prenatal Exposure

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This is a summary of the recent article, Self-regulation and emotional reactivity in infants with prenatal exposure to opioids and alcohol that is featured in CanFASD’s Top FASD Articles for 2020. For a complete understanding of the subject matter, we encourage you to read the full paper.


Over the last 13 years, there has been a 127% increase in opioid use disorders during pregnancy. However, developmental challenges associated with prenatal substance exposure have been under-explored, with no prior studies examining the combined effects of opioids and alcohol use during pregnancy.

The researchers in this study used data from 100 mother-child pairs to understand the impact prenatal substance use exposure had on infant self-regulation and the association between self-regulation and the infant’s affect. The pairs were recruited through another study called ENRICH between 2013 and 2018. Using the data from this study, the researchers divided the pairings into four groups: (1) no prenatal substance exposure; (2) prenatally exposure to alcohol; (3) mothers who were on medication for opioid use disorder (MOUD); and (4) prenatally exposure to both alcohol and MOUD.


The researchers found that:

  • Infants exposed to both MOUD and alcohol had the lowest levels of self-regulation;
  • Higher self-regulation was associated with lower negative affect in infants with both alcohol and MOUD, but not in the other groups;
  • Baseline self-regulation was a significant predictor of an infant’s ability to self-regulate during the “still face” (an interaction between the mother and child where the mother keeps a neutral face and doesn’t respond or react to the child) and play episodes, suggesting baseline self-regulation is an indication of self-regulation during stressful experiences; and
  • The results of this study suggest that prenatal exposure to both alcohol and opioids can impact behavioural reactivity to a stressor.

Alcohol and opioid use in pregnancy is an under-researched field. The results of this study demonstrate the impact of prenatal substance exposure on self-regulation and the ability to process stress. The researchers found that infants with polysubstance exposure had the lowest baseline levels of self-regulation, and that baseline self-regulation predicts self-regulation strategies under stress. However, these results should be considered with caution as the sample size was relatively small and some potentially confounding sociodemographic variables were not collected. Future studies are needed to investigate the contributions of maternal mood and mental health comorbidities to infant emotional reactivity and to explore self-regulation throughout an individual’s childhood.

Journal: Early Human Development

Authors: Kathryn Beauchamp, Jean Lowe, Ronald Schrader, Shikhar Shrestha, Crystal Aragón, Natalie Moss, Julia Stephen, and Ludmila Bakhireva.

Date: September 2020

Read the full article (not available open access)

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