Epidemiology of opioid use in pregnancy

Cook, Jocelynn L.

doi:10.1016/j.bpobgyn.2022.07.008

Cited by 10 publications

(8 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The obstetric management of opioid-dependent pregnant women is challenging because of the multiple medical complications resulting from chronic intravenous opiate abuse. Infections, particularly hepatitis A, B, and C; tuberculosis; bacterial endocarditis; septicemia; cellulitis; and sexually transmitted diseases, are major contributors to these complications [ 1 , 94 , 95 ]. In addition, the care of opioid-dependent women at risk of complications in the peripartum period is particularly challenging.…”

Section: Discussionmentioning

confidence: 99%

“…NOWS in infants of methadone-maintained opioid-dependent mothers was investigated, and pharmacogenetic analysis of candidate genes was conducted to identify genetic variants that might have made infants susceptible to either MTD accumulation or heightened sensitivity, as part of the investigations of death [ 16 , 21 , 48 , 70 , 78 , 90 , 94 , 95 ]. Methadone metabolism can be modified by polymorphic variations of CYP2B6 and ABCB1 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Fetal and Infant Effects of Maternal Opioid Use during Pregnancy: A Literature Review including Clinical, Toxicological, Pharmacogenomic, and Epigenetic Aspects for Forensic Evaluation

Giovannini,

Bonasoni,

Pascali

et al. 2024

Children

View full text Add to dashboard Cite

The two primary classes of opioid substances are morphine and its synthetic derivative, heroin. Opioids can cross the placental barrier, reaching fetal circulation. Therefore, at any gestational age, the fetus is highly exposed to pharmacologically active opioid metabolites and their associated adverse effects. This review aimed to investigate all the studies reported in a timeframe of forty years about prenatal and postnatal outcomes of opioid exposition during pregnancy. Clinical and toxicological aspects, as well as pharmacogenetic and epigenetic research focusing on fetal and infant effects of opioid use during pregnancy together with their medico-legal implications are exposed and discussed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Fetal and Infant Effects of Maternal Opioid Use during Pregnancy: A Literature Review including Clinical, Toxicological, Pharmacogenomic, and Epigenetic Aspects for Forensic Evaluation

Giovannini,

Bonasoni,

Pascali

et al. 2024

Children

View full text Add to dashboard Cite

show abstract

“…The fentanyl exposure time frame was chosen as it is roughly analogous to the last trimester of human pregnancy in terms of brain development ( Schmitt and Barrow, 2022 ). While the third trimester only is not the most common exposure period for human women, it does represent a significant percentage of women who are prescribed opioids for pain during pregnancy ( Cook, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Effects of neonatal fentanyl on late adolescent opioid-mediated behavior

Crawford

Taylor²,

Park³

et al. 2023

Front. Neurosci.

View full text Add to dashboard Cite

IntroductionBecause of the steady increase in the use of synthetic opioids in women of childbearing age, a large number of children are at risk of exposure to these drugs prenatally or postnatally through breast milk. While there is older literature looking at the effects of morphine and heroin, there are relatively few studies looking at the long-term effects of high-potency synthetic opioid compounds like fentanyl. Thus, in the present study, we assessed whether brief exposure to fentanyl in male and female rat pups during a period roughly equivalent to the third trimester of CNS development altered adolescent oral fentanyl self-administration and opioid-mediated thermal antinociception.MethodsWe treated the rats with fentanyl (0, 10, or 100 μg/kg sc) from postnatal day (PD) 4 to PD 9. The fentanyl was administered daily in two injections given 6 h apart. After the last injection on PD 9, the rat pups were left alone until either PD 40 where they began fentanyl self-administration training or PD 60 where they were tested for morphine- (0, 1.25, 2.5, 5, or 10 mg/kg) or U50,488- (0, 2.5, 5, 10, or 20 mg/kg) induced thermal antinociception.ResultsIn the self-administration study, we found that female rats had more active nose pokes than male rats when receiving a fentanyl reward but not sucrose alone solution. Early neonatal fentanyl exposure did not significantly alter fentanyl intake or nose-poke response. In contrast, early fentanyl exposure did alter thermal antinociception in both male and female rats. Specifically, fentanyl (10 μg/kg) pre-treatment increased baseline paw-lick latencies, and the higher dose of fentanyl (100 μg/kg) reduced morphine-induced paw-lick latencies. Fentanyl pre-treatment did not alter U50,488-mediated thermal antinociception.ConclusionsAlthough our exposure model is not reflective of typical human fentanyl use during pregnancy, our study does illustrate that even brief exposure to fentanyl during early development can have long-lasting effects on mu-opioid-mediated behavior. Moreover, our data suggest that females may be more susceptible to fentanyl abuse than males.

show abstract

“…As the opioid epidemic has progressed over the past two decades, opioid use disorder has increased in pregnant women leading to an alarming rise in the number of babies being born with prenatal opioid exposure (POE) and undergoing neonatal opioid withdrawal [1][2][3]. Prenatal exposure to opioids produces adverse health consequences at birth with substantial neurobehavioral disruptions that persist at least into adolescence if not longer [2][3][4]. Clinical neuroimaging studies reveal macrostructural and morphometric disturbances in infants with POE, as well as profound alterations in functional connectivity [5].…”

Section: Introductionmentioning

confidence: 99%

Perturbed neurochemical and microstructural organization in a mouse model of prenatal opioid exposure: a multi-modal magnetic resonance study

Shahid

Grecco

Brady

et al. 2023

Preprint

View full text Add to dashboard Cite

Methadone-based treatment for pregnant women with opioid use disorder is quite prevalent in the clinical environment. A number of clinical and animal model-based studies have reported cognitive deficits in infants prenatally exposed to methadone-based opioid treatments. However, the long-term impact of prenatal opioid exposure (POE) on pathophysiological mechanisms that govern neurodevelopmental impairment is not well understood. Using a translationally relevant mouse model of prenatal methadone exposure (PME), the aim of this study is to investigate the role of cerebral biochemistry and its possible association with regional microstructural organization in PME offspring. To understand these effects, 8-week-old male offspring with PME (n=7) and prenatal saline exposure (PSE) (n=7) were scanned in vivo on 9.4 Tesla small animal scanner. Single voxel proton magnetic resonance spectroscopy (1H-MRS) was performed in the right dorsal striatum (RDS) region using a short echo time (TE) Stimulated Echo Acquisition Method (STEAM) sequence. Neurometabolite spectra from the RDS was first corrected for tissue T1 relaxation and then absolute quantification was performed using the unsuppressed water spectra. High-resolution in vivo diffusion MRI (dMRI) for region of interest (ROI) based microstructural quantification was also performed using a multi-shell dMRI sequence. Cerebral microstructure was characterized using diffusion tensor imaging (DTI) and Bingham-neurite orientation dispersion and density imaging (Bingham-NODDI). MRS results in the RDS showed significant decrease in N-acetyl aspartate (NAA), taurine (tau), glutathione (GSH), total creatine (tCr) and glutamate (Glu) concentration levels in PME, compared to PSE group. In the same RDS region, mean orientation dispersion index (ODI) and intracellular volume fraction (VFIC) demonstrated positive associations with tCr in PME group. ODI also exhibited significant positive association with Glu levels in PME offspring. Significant reduction in major neurotransmitter metabolites and energy metabolism along with strong association between the neurometabolites and perturbed regional microstructural complexity suggest a possible impaired neuroadaptation trajectory in PME offspring which could be persistent even into late adolescence and early adulthood.

show abstract

Epidemiology of opioid use in pregnancy

Cited by 10 publications

References 43 publications

Fetal and Infant Effects of Maternal Opioid Use during Pregnancy: A Literature Review including Clinical, Toxicological, Pharmacogenomic, and Epigenetic Aspects for Forensic Evaluation

Fetal and Infant Effects of Maternal Opioid Use during Pregnancy: A Literature Review including Clinical, Toxicological, Pharmacogenomic, and Epigenetic Aspects for Forensic Evaluation

Effects of neonatal fentanyl on late adolescent opioid-mediated behavior

Perturbed neurochemical and microstructural organization in a mouse model of prenatal opioid exposure: a multi-modal magnetic resonance study

Contact Info

Product

Resources

About