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We assessed relationships between placental DNA methylation with in-utero opioid exposure and NOWS severity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Secondary analysis of a prospective multicenter cohort study of pregnancies on methadone or buprenorphine, \u226534 weeks, singleton, 18 or greater. Placental biopsies were collected. Placental DNA methylation levels of <jats:italic>ABCG1, ABCG2, CYP19A1<\/jats:italic>, and <jats:italic>HSD11B2<\/jats:italic> were quantified via pyrosequencing following bisulfite conversion. CYP19A1 mRNA levels and umbilical cord drug levels were determined by RT-qPCR and LC-MS respectively. Severe NOWS was diagnosed through Finnegan scoring. <jats:italic>P<\/jats:italic> value\u2009&lt;\u20090.05 was significant.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Thirty-eight dyads were included. Promoter region methylation for placental <jats:italic>ABCB1<\/jats:italic> was lower in severe NOWS compared to non-severe NOWS (<jats:italic>p<\/jats:italic>\u2009=\u20090.04). Placental <jats:italic>CYP19A1<\/jats:italic> methylation was inversely related to <jats:italic>CYP19A1<\/jats:italic> mRNA levels and associated with umbilical cord norbuprenorphine levels (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), but not umbilical cord methadone levels.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Discussion<\/jats:title>\n            <jats:p>Lower placental <jats:italic>ABCB1<\/jats:italic> methylation was associated with severe NOWS. Higher placental <jats:italic>CYP19A1<\/jats:italic> methylation correlated with higher umbilical cord norbuprenorphine levels.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41372-024-02060-9","type":"journal-article","created":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T18:01:43Z","timestamp":1721498503000},"page":"458-464","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Increased risk of severe neonatal opioid withdrawal syndrome in pregnancies with low placental ABCB1 DNA methylation"],"prefix":"10.1038","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6650-9091","authenticated-orcid":false,"given":"Courtney","family":"Townsel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burnley","family":"Truax","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6294-2429","authenticated-orcid":false,"given":"Margaret","family":"Quaid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Covault","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana C.","family":"Dolinoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaclyn M.","family":"Goodrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,20]]},"reference":[{"key":"2060_CR1","unstructured":"About opioid use during pregnancy | CDC [Internet]. 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Informed consent was obtained from all subjects. (b) Named ethics committee: n\/a (c) Informed consent was obtained from all subjects. (d) When publishing identifiable images from human research participants, please state that the authors have obtained informed consent for publication of the images. n\/a.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}