Work

Neonatal outcomes and immune reprogramming induced by prenatal opioid and hepatitis C exposure

Year: 2026

Type: article

Abstract: Introduction: Prenatal opioid exposure (POE) is an escalating public health concern. However, its impact on neonatal immune development remains poorly defined. This study examined how POE, with or without maternal hepatitis C (hepatitis C virus, HCV) infection, shapes neonatal immunity. Methods: Umbilical cord blood was collected from pregnancies included uncomplicated term controls (n=38) and deliveries in patients with severe opioid use disorder on medication-assisted treatment, with (n=41) or without HCV (n=34) infection. Flow cytometry was used to characterize cell phenotype and functional response to stimulation. Single-cell RNA sequencing was used to investigate transcriptomics changes. Results: POE was associated with smaller birth size, higher rates of congenital anomalies, and longer intensive care admissions. Immune profiling showed a proinflammatory milieu, reduced circulating levels of neuroprotective factors, expanded memory/effector T and B cells, blunted T-cell responses, and markedly reduced natural killer (NK) cell frequency and cytotoxicity, especially in POE HCV+ newborns. Monocytes exhibited inflammatory reprogramming with impaired antiviral and tissue repair pathways and disrupted lymphoid-innate immune cell communication. Discussion: These findings suggest that POE-driven immune disequilibrium may underlie adverse early-life outcomes and highlight monitoring and intervention targets.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1794914