title: Neonatal Abstinence Syndrome: Presentation and Treatment Considerations.
abstract: This clinical case conference discusses the treatment of a pregnant woman with opioid use disorder in a comprehensive care program that includes buprenorphine pharmacotherapy. The presentation summarizes common experiences that pregnant women who receive buprenorphine pharmacotherapy face, and also what their prenatally opioid-exposed children confront in the immediate postpartum period. It describes the elements of a successful comprehensive care model and corollary neonatal abstinence syndrome treatment regimen. Expert commentary is included on issues that arise in the buprenorphine induction and maintenance throughout the prenatal and postpartum periods and in the treatment of co-occurring mental health problems during both the prenatal and postpartum periods, particularly the treatment of depression. There is also expert commentary on the care of opioid-exposed neonates, with attention to the treatment for neonatal abstinence syndrome.
authors.affiliation: UNC Horizons and Department of Obstetrics and Gynecology (HEJ), University of North Carolina at Chapel Hill, Chapel Hill, NC; Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology (HEJ, EJ), School of Medicine, John Hopkins University, Baltimore, MD; Emeritus Professor of Pediatrics (KK), Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA; UNC Horizons and Department of Pediatrics (CS, EF), University of North Carolina at Chapel Hill, Chapel Hill, NC; and UNC Horizons and Department of Psychiatry (EM), University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Hendrée E
authors.initials: HE
authors.lastname: Jones
authors.forename: Karol
authors.initials: K
authors.lastname: Kaltenbach
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Johnson
authors.forename: Carl
authors.initials: C
authors.lastname: Seashore
authors.forename: Emily
authors.initials: E
authors.lastname: Freeman
authors.forename: Erin
authors.initials: E
authors.lastname: Malloy
mesh_terms: D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009020:Morphine / Q000008:administration & dosage / Q000494:pharmacology; D009270:Naloxone / Q000008:administration & dosage / Q000494:pharmacology; D009292:Narcotic Antagonists / Q000008:administration & dosage / Q000494:pharmacology*; D009294:Narcotics / Q000008:administration & dosage / Q000494:pharmacology*; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy* / Q000209:etiology; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*
chemical_list: D009292:Narcotic Antagonists; D009294:Narcotics; D009270:Naloxone; D002047:Buprenorphine; D009020:Morphine