Analgesia, Opioids, and Other Drug Use During Pregnancy and Neonatal Abstinence Syndrome

Hendrée E Jones; Walter K Kraft

doi:10.1016/j.clp.2019.02.013

Analgesia, Opioids, and Other Drug Use During Pregnancy and Neonatal Abstinence Syndrome

Clin Perinatol. 2019 Jun;46(2):349-366. doi: 10.1016/j.clp.2019.02.013. Epub 2019 Mar 30.

Authors

Hendrée E Jones¹, Walter K Kraft²

Affiliations

¹ Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, UNC Horizons, 410 North Greensboro Street, Chapel Hill, NC, USA; Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA. Electronic address: Hendree_Jones@med.unc.edu.
² Clinical Research Unit, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, 1170 Main Building, 132 South 10th Street, Philadelphia, PA 19107-5244, USA.

PMID: 31010564
DOI: 10.1016/j.clp.2019.02.013

Abstract

When opioid misuse rises in the United States, pregnant women and their neonates are affected. This article summarizes the use of Food and Drug Administration-approved products, including methadone, buprenorphine, and the combination formulation of buprenorphine and naloxone to treat adult opioid use disorder during the perinatal period. All labels include pregnancy, neonatal, and lactation information and note the accepted use of these medications during the perinatal period if the benefits outweigh the risks. A summary of the neonatal abstinence syndrome definition, its assessment tools, treatment approaches, and future genetic directions are provided.

Keywords: Addiction; NAS; NOWS; Neonatal; Neonatal abstinence syndrome; Neonatal opioid withdrawal; Opioid use disorder; Prenatal.

Publication types

Review

MeSH terms

Analgesia, Obstetrical
Analgesics / therapeutic use
Analgesics, Opioid / therapeutic use*
Breast Feeding
Buprenorphine / therapeutic use
Buprenorphine, Naloxone Drug Combination / therapeutic use
Clonidine / therapeutic use
Female
Humans
Hypnotics and Sedatives / therapeutic use
Infant, Newborn
Kangaroo-Mother Care Method
Maternal-Fetal Exchange
Methadone / therapeutic use
Neonatal Abstinence Syndrome / therapy*
Occupational Therapy
Opiate Substitution Treatment*
Opioid-Related Disorders / therapy*
Pain Management
Patient Education as Topic
Phenobarbital / therapeutic use
Physical Therapy Modalities
Pregnancy
Pregnancy Complications / therapy*
Rooming-in Care

Substances

Analgesics
Analgesics, Opioid
Buprenorphine, Naloxone Drug Combination
Hypnotics and Sedatives
Buprenorphine
Clonidine
Methadone
Phenobarbital