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In Utero Drug Withdrawal

MedGen UID:
769756
•Concept ID:
C3641116
•
Mental or Behavioral Dysfunction

Definition

Drug withdrawal symptoms in a fetus following maternal discontinuation or reduction of use of one or more addictive substance(s) that have caused fetal physiological dependence. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVIn Utero Drug Withdrawal

Professional guidelines

PubMed

Opioid Treatment for Neonatal Opioid Withdrawal Syndrome: Current Challenges and Future Approaches.
McPhail BT, Emoto C, Butler D, Fukuda T, Akinbi H, Vinks AA
J Clin Pharmacol 2021 Jul;61(7):857-870. Epub 2021 Feb 1 doi: 10.1002/jcph.1811. PMID: 33382111
Interventions for the Treatment of Neonatal Abstinence Syndrome.
Cook CE, Fantasia HC
Nurs Womens Health 2019 Aug;23(4):357-365. Epub 2019 Jun 25 doi: 10.1016/j.nwh.2019.05.006. PMID: 31251931
Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.
Wachman EM, Schiff DM, Silverstein M
JAMA 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. PMID: 29614184

Recent clinical studies

Etiology

Duration and Timing of In Utero Opioid Exposure and Incidence of Neonatal Withdrawal Syndrome.
Wang Y, Berger L, Durrance C, Kirby RS, Kuo D, Pac J, Ehrenthal DB
Obstet Gynecol 2023 Sep 1;142(3):603-611. doi: 10.1097/AOG.0000000000005289. PMID: 37548391Free PMC Article
Family planning considerations in people with multiple sclerosis.
Krysko KM, Dobson R, Alroughani R, Amato MP, Bove R, Ciplea AI, Fragoso Y, Houtchens M, Jokubaitis VG, Magyari M, Abdelnasser A, Padma V, Thiel S, Tintore M, Vukusic S, Hellwig K
Lancet Neurol 2023 Apr;22(4):350-366. doi: 10.1016/S1474-4422(22)00426-4. PMID: 36931808
Prenatal Opioid Exposure and Neurodevelopmental Outcomes.
Lee JJ, Saraiya N, Kuzniewicz MW
J Neurosurg Anesthesiol 2023 Jan 1;35(1):142-146. Epub 2022 Dec 6 doi: 10.1097/ANA.0000000000000876. PMID: 36745179
Evidence-Based Contraception: Common Questions and Answers.
Paradise SL, Landis CA, Klein DA
Am Fam Physician 2022 Sep;106(3):251-259. PMID: 36126006
The placenta as a target of opioid drugs†.
Rosenfeld CS
Biol Reprod 2022 Apr 26;106(4):676-686. doi: 10.1093/biolre/ioac003. PMID: 35024817Free PMC Article

Diagnosis

Duration and Timing of In Utero Opioid Exposure and Incidence of Neonatal Withdrawal Syndrome.
Wang Y, Berger L, Durrance C, Kirby RS, Kuo D, Pac J, Ehrenthal DB
Obstet Gynecol 2023 Sep 1;142(3):603-611. doi: 10.1097/AOG.0000000000005289. PMID: 37548391Free PMC Article
Family planning considerations in people with multiple sclerosis.
Krysko KM, Dobson R, Alroughani R, Amato MP, Bove R, Ciplea AI, Fragoso Y, Houtchens M, Jokubaitis VG, Magyari M, Abdelnasser A, Padma V, Thiel S, Tintore M, Vukusic S, Hellwig K
Lancet Neurol 2023 Apr;22(4):350-366. doi: 10.1016/S1474-4422(22)00426-4. PMID: 36931808
The placenta as a target of opioid drugs†.
Rosenfeld CS
Biol Reprod 2022 Apr 26;106(4):676-686. doi: 10.1093/biolre/ioac003. PMID: 35024817Free PMC Article
Standardizing the Clinical Definition of Opioid Withdrawal in the Neonate.
Jilani SM, Jones HE, Grossman M, Jansson LM, Terplan M, Faherty LJ, Khodyakov D, Patrick SW, Davis JM
J Pediatr 2022 Apr;243:33-39.e1. Epub 2021 Dec 20 doi: 10.1016/j.jpeds.2021.12.021. PMID: 34942181
Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.
Wachman EM, Schiff DM, Silverstein M
JAMA 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. PMID: 29614184

Therapy

Evidence-Based Contraception: Common Questions and Answers.
Paradise SL, Landis CA, Klein DA
Am Fam Physician 2022 Sep;106(3):251-259. PMID: 36126006
Opioid Use in Pregnancy.
Tobon AL, Habecker E, Forray A
Curr Psychiatry Rep 2019 Nov 16;21(12):118. doi: 10.1007/s11920-019-1110-4. PMID: 31734808Free PMC Article
Interventions for the Treatment of Neonatal Abstinence Syndrome.
Cook CE, Fantasia HC
Nurs Womens Health 2019 Aug;23(4):357-365. Epub 2019 Jun 25 doi: 10.1016/j.nwh.2019.05.006. PMID: 31251931
Pharmacological and non-pharmacological treatments for the Neonatal Abstinence Syndrome (NAS).
Mangat AK, Schmölzer GM, Kraft WK
Semin Fetal Neonatal Med 2019 Apr;24(2):133-141. Epub 2019 Feb 5 doi: 10.1016/j.siny.2019.01.009. PMID: 30745219Free PMC Article
Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.
Wachman EM, Schiff DM, Silverstein M
JAMA 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. PMID: 29614184

Prognosis

Duration and Timing of In Utero Opioid Exposure and Incidence of Neonatal Withdrawal Syndrome.
Wang Y, Berger L, Durrance C, Kirby RS, Kuo D, Pac J, Ehrenthal DB
Obstet Gynecol 2023 Sep 1;142(3):603-611. doi: 10.1097/AOG.0000000000005289. PMID: 37548391Free PMC Article
Placental DNA methylation profiles in opioid-exposed pregnancies and associations with the neonatal opioid withdrawal syndrome.
Radhakrishna U, Vishweswaraiah S, Uppala LV, Szymanska M, Macknis J, Kumar S, Saleem-Rasheed F, Aydas B, Forray A, Muvvala SB, Mishra NK, Guda C, Carey DJ, Metpally RP, Crist RC, Berrettini WH, Bahado-Singh RO
Genomics 2021 May;113(3):1127-1135. Epub 2021 Mar 9 doi: 10.1016/j.ygeno.2021.03.006. PMID: 33711455
Opioid Treatment for Neonatal Opioid Withdrawal Syndrome: Current Challenges and Future Approaches.
McPhail BT, Emoto C, Butler D, Fukuda T, Akinbi H, Vinks AA
J Clin Pharmacol 2021 Jul;61(7):857-870. Epub 2021 Feb 1 doi: 10.1002/jcph.1811. PMID: 33382111
Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.
Wachman EM, Schiff DM, Silverstein M
JAMA 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. PMID: 29614184
Short- and long-term complications of in utero exposure to lamotrigine.
Cohen-Israel M, Berger I, Martonovich EY, Klinger G, Stahl B, Linder N
Br J Clin Pharmacol 2018 Jan;84(1):189-194. Epub 2017 Oct 22 doi: 10.1111/bcp.13437. PMID: 29044597Free PMC Article

Clinical prediction guides

Duration and Timing of In Utero Opioid Exposure and Incidence of Neonatal Withdrawal Syndrome.
Wang Y, Berger L, Durrance C, Kirby RS, Kuo D, Pac J, Ehrenthal DB
Obstet Gynecol 2023 Sep 1;142(3):603-611. doi: 10.1097/AOG.0000000000005289. PMID: 37548391Free PMC Article
Neonatal Withdrawal Syndrome following Late in utero Exposure to Selective Serotonin Reuptake Inhibitors: A Systematic Review and Meta-Analysis of Observational Studies.
Wang J, Cosci F
Psychother Psychosom 2021;90(5):299-307. Epub 2021 May 10 doi: 10.1159/000516031. PMID: 33971648
Opioid Treatment for Neonatal Opioid Withdrawal Syndrome: Current Challenges and Future Approaches.
McPhail BT, Emoto C, Butler D, Fukuda T, Akinbi H, Vinks AA
J Clin Pharmacol 2021 Jul;61(7):857-870. Epub 2021 Feb 1 doi: 10.1002/jcph.1811. PMID: 33382111
Pharmacological and non-pharmacological treatments for the Neonatal Abstinence Syndrome (NAS).
Mangat AK, Schmölzer GM, Kraft WK
Semin Fetal Neonatal Med 2019 Apr;24(2):133-141. Epub 2019 Feb 5 doi: 10.1016/j.siny.2019.01.009. PMID: 30745219Free PMC Article
Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.
Wachman EM, Schiff DM, Silverstein M
JAMA 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. PMID: 29614184

Recent systematic reviews

Neonatal Withdrawal Syndrome following Late in utero Exposure to Selective Serotonin Reuptake Inhibitors: A Systematic Review and Meta-Analysis of Observational Studies.
Wang J, Cosci F
Psychother Psychosom 2021;90(5):299-307. Epub 2021 May 10 doi: 10.1159/000516031. PMID: 33971648
Outcome reporting in neonates experiencing withdrawal following opioid exposure in pregnancy: a systematic review.
Shan F, MacVicar S, Allegaert K, Offringa M, Jansson LM, Simpson S, Moulsdale W, Kelly LE
Trials 2020 Mar 12;21(1):262. doi: 10.1186/s13063-020-4183-9. PMID: 32164782Free PMC Article
Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding.
Lethaby A, Hussain M, Rishworth JR, Rees MC
Cochrane Database Syst Rev 2015 Apr 30;(4):CD002126. doi: 10.1002/14651858.CD002126.pub3. PMID: 25924648
Hormone therapy in postmenopausal women and risk of endometrial hyperplasia.
Furness S, Roberts H, Marjoribanks J, Lethaby A
Cochrane Database Syst Rev 2012 Aug 15;2012(8):CD000402. doi: 10.1002/14651858.CD000402.pub4. PMID: 22895916Free PMC Article
Danazol for heavy menstrual bleeding.
Beaumont H, Augood C, Duckitt K, Lethaby A
Cochrane Database Syst Rev 2007 Jul 18;2007(3):CD001017. doi: 10.1002/14651858.CD001017.pub2. PMID: 17636649Free PMC Article

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