Abstract

Opiate use during pregnancy has been an increasing problem over the last two decades, making it an important social and health concern. The use of such substances may have serious negative outcomes in the newborn, and clinical and cognitive conditions have been reported, including neonatal abstinence syndrome, developmental problems, and lower cognitive performance. These conditions are common when opiates are used during pregnancy, making the prescription of these kinds of drugs problematic. Moreover, the mother may develop opiate addiction, thus, increasing the likelihood of the infant being born with any of those conditions. This paper reviews the use of opiates during pregnancy and focuses mainly on the neonatal abstinence syndrome. First, the commonly prescribed opiates will be identified, namely those usually involved in cases of addiction and/or neonatal abstinence syndrome. Second, published approaches to deal with those problems will be presented and discussed, including the treatment of both the mother and the infant. Finally, we will outline the treatments that are safest and most efficient, and will define future goals, approaches, and research directions for the scientific community regarding this problem.

Highlights

  • Opioids are narcotic drugs that act on opioid receptors

  • Guidelines have been published by Centers for Disease Control (CDC) to specify those situations where opioid prescription is recommended, and identifying indirect problems arising from the actual clinical practice regarding the use of these drugs

  • In a cohort study performed in 46 states of the United States of America, it was verified that opioids such as codeine, oxycodone, hydrocodone, and propoxyphene were the most prescribed compounds, and as such could be considered responsible for most of the neonatal abstinence syndrome (NAS)

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Summary

Introduction

Opioids are narcotic drugs that act on opioid receptors. This results in an analgesic effect, and these compounds are used worldwide mainly for the treatment of acute and chronic pain. Methadone dispensed under the scope of maintenance treatment programs was not included as well This increase was not exclusive to North America, as an increase in opioid consumption was observed in Denmark, Norway, Finland, Sweden, and Iceland [4]. Alternative approaches should be used whenever possible, for instance using acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), as these represent safer options that have a low risk of addiction problems compared to opioids. These alternative approaches have been proven to be very useful in the treatment of pain [6]. Neonatal abstinence syndrome, including diagnosis and treatment-related aspects, will be discussed thereafter

Research Methodology
Opioids Use during Pregnancy
Neonatal Abstinence Syndrome
Medical Scoring Tools
Analysis of Biological Specimens
Opioid Addiction in Pregnancy—Treatment
Neonatal Abstinence Syndrome—Treatment
Healthcare Professionals’ Attitudes
Findings
Conclusions and Future Perspectives
Full Text
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