TY - JOUR
KW - Buprenorphine/therapeutic use
KW - Child Development/drug effects
KW - Female
KW - Humans
KW - Infant, Newborn
KW - Methadone/therapeutic use
KW - Neonatal Abstinence Syndrome/prevention & control
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy
KW - Pregnancy
KW - Pregnancy Complications/drug therapy
KW - Treatment Outcome
KW - Antenatal
KW - Drug
KW - Opioid
KW - Opioids
KW - Perinatal
KW - Postpartum
AU - A. L. Tobon
AU - E. Habecker
AU - A. Forray
A1 - 
AB - PURPOSE OF REVIEW: Perinatal opioid use is a major public health problem and is associated with a number of deleterious maternal and fetal effects. We review recent evidence of perinatal outcomes and treatment of opioid use disorder (OUD) during pregnancy. RECENT FINDINGS: Opioid exposure in pregnancy is associated with multiple obstetric and neonatal adverse outcomes, with the most common being neonatal opioid withdrawal syndrome (NOWS). Treatment with buprenorphine or methadone is associated with NOWS, but neither medication appears to have significant adverse effects on early childhood development. Buprenorphine appears to be superior to methadone in terms of incidence and severity of NOWS in exposed infants. The long-term effects of opioid exposure in utero have been inconclusive, but recent longitudinal studies point to potential differences in brain morphology that may increase vulnerability to future stressors. Maintenance therapy with methadone or buprenorphine remains the standard of care for pregnant women with OUD given its consistent superiority to placebo in terms of rates of illicit drug use and pregnancy outcomes. New non-pharmacologic management options for NOWS appear promising. Future research is needed to further evaluate the effects of opioid exposure in utero and determine the optimal delivery model for maintenance therapy.
AD - Department of Psychiatry, Yale School of Medicine, 40 Temple Street, Suite 6B, New Haven, CT, 06510, USA.; Department of Psychiatry, Yale School of Medicine, 40 Temple Street, Suite 6B, New Haven, CT, 06510, USA.; Department of Psychiatry, Yale School of Medicine, 40 Temple Street, Suite 6B, New Haven, CT, 06510, USA. ariadna.forray@yale.edu.
BT - Current psychiatry reports
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 12
CY - United States
DO - 10.1007/s11920-019-1110-4
IS - 12
JF - Current psychiatry reports
LA - eng
M1 - Journal Article
N2 - PURPOSE OF REVIEW: Perinatal opioid use is a major public health problem and is associated with a number of deleterious maternal and fetal effects. We review recent evidence of perinatal outcomes and treatment of opioid use disorder (OUD) during pregnancy. RECENT FINDINGS: Opioid exposure in pregnancy is associated with multiple obstetric and neonatal adverse outcomes, with the most common being neonatal opioid withdrawal syndrome (NOWS). Treatment with buprenorphine or methadone is associated with NOWS, but neither medication appears to have significant adverse effects on early childhood development. Buprenorphine appears to be superior to methadone in terms of incidence and severity of NOWS in exposed infants. The long-term effects of opioid exposure in utero have been inconclusive, but recent longitudinal studies point to potential differences in brain morphology that may increase vulnerability to future stressors. Maintenance therapy with methadone or buprenorphine remains the standard of care for pregnant women with OUD given its consistent superiority to placebo in terms of rates of illicit drug use and pregnancy outcomes. New non-pharmacologic management options for NOWS appear promising. Future research is needed to further evaluate the effects of opioid exposure in utero and determine the optimal delivery model for maintenance therapy.
PP - United States
PY - 2019
SN - 1535-1645; 1523-3812
SP - 019
EP - 4
EP - 118+
T1 - Opioid Use in Pregnancy
T2 - Current psychiatry reports
TI - Opioid Use in Pregnancy
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 31734808
U3 - 10.1007/s11920-019-1110-4
VL - 21
VO - 1535-1645; 1523-3812
Y1 - 2019
Y2 - Nov 16
ER -