title: Opioids in pregnancy and neonatal abstinence syndrome.
abstract: Opiate use in pregnancy has increased dramatically over the past decade and now represents a major public health problem. More women are using prescription opioids, illegal opioids, and opioid-substitution therapy. These drugs have been associated with numerous obstetrical complications including intrauterine growth restriction, placental abruption, preterm delivery, oligohydramnios, stillbirth, and maternal death. Neonatal complications are also significant, such as an increased risk of mortality as well as neonatal abstinence syndrome (NAS). NAS is a serious and highly variable condition characterized by central nervous system hyperirritability and autonomic nervous system dysfunction. The present review seeks to define current practices regarding the management of opiate dependence in pregnancy and care of the neonate with prenatal opiate exposure. Since genetic factors appear to be associated with the incidence and severity of NAS, opportunities for "personalized genomic medicine" and unique therapeutic interventions could be developed in the future.
authors.affiliation: The Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, MA.
authors.forename: Megan W
authors.initials: MW
authors.lastname: Stover
authors.affiliation: The Department of Pediatrics, The Floating Hospital for Children at Tufts Medical Center, TMC 44, 800 Washington Street, Boston, MA 02111; Tufts Clinical and Translational Science Institute, Boston, MA. Electronic address: jdavis@tuftsmedicalcenter.org.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Davis
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D009035:Mothers / Q000523:psychology; D009357:Neonatal Abstinence Syndrome / Q000097:blood / Q000453:epidemiology*; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000097:blood / Q000150:complications* / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000209:etiology* / Q000523:psychology; D037841:Pregnant People / Q000523:psychology; D047928:Premature Birth / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid
keywords: Neonatal abstinence syndrome; Newborn; Opioids; Pregnancy