Impact of
            <i>in utero</i>
            opioid exposure on newborn outcomes: beyond neonatal opioid withdrawal syndrome

Bailey, Beth A.; Shah, Darshan; Boynewicz, Kara; Justice, Nathaniel; Wood, David L.

doi:10.1080/14767058.2022.2035713

Cited by 10 publications

(8 citation statements)

References 30 publications

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“…This finding is in alignment with several studies looking at the effect of specific substances on fetal growth. A study by Bailey et al, which examined the impact of opioid use on newborn outcomes, found that infants exposed to opioids were more than twice as likely to be diagnosed with growth restriction and decreased birth weight [22] . Additionally, Janisse et al examined the effect of several types of substances on PTB and FGR using path analysis of the impact of substance abuse on decreased birth weight.…”

Section: Discussionmentioning

confidence: 99%

Perinatal substance use disorder: Examining the impact on adverse pregnancy outcomes

Ragsdale,

Al-Hammadi,

Loux

et al. 2024

European Journal of Obstetrics & Gynecology and Reproductiv

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Section: Discussionmentioning

confidence: 99%

Perinatal substance use disorder: Examining the impact on adverse pregnancy outcomes

Ragsdale,

Al-Hammadi,

Loux

et al. 2024

European Journal of Obstetrics & Gynecology and Reproductiv

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“…significant concerns (5,29,35,(62)(63)(64)(65)(66)(67)(68)(69). Children born to opioiddependent pregnant people have a greater likelihood of being impaired in two or more domains at school entry compared to non-opioid exposed children, and they carry their risk for educational delay throughout their school years (5,35,(66)(67)(68)(69).…”

Section: Discussionmentioning

confidence: 99%

“…From a broader public health perspective, clinical practice guidelines suggest that treating OUD with methadone or buprenorphine is safer than abstinence or withdrawal during pregnancy (65,(86)(87)(88)(89). The evidence reviewed above, however, suggests that long-term neurocognitive sequelae are not fully mitigated by replacement strategies and that there is potential for untold consequences on neural cell maturation, circuit formation and plasticity.…”

Section: Discussionmentioning

confidence: 99%

In utero methadone exposure permanently alters anatomical and functional connectivity: A preclinical evaluation

et al. 2023

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The opioid epidemic is an ongoing public health crisis, and children born following prenatal opioid exposure (POE) have increased risk of long-term cognitive and behavioral sequelae. Clinical studies have identified reduced gray matter volume and abnormal white matter microstructure in children with POE but impacts on whole-brain functional brain connectivity (FC) have not been reported. To define effects of POE on whole brain FC and white matter injury in adult animals, we performed quantitative whole-brain structural and functional MRI. We used an established rat model of POE in which we have previously reported impaired executive function in adult rats analogous to persistent neurocognitive symptoms described in humans with POE. Pregnant Sprague-Dawley rat dams received continuous methadone (12 mg/kg/day) vs. saline infusion for 28 days via osmotic mini-pumps, exposing rats to pre- and postnatal opioid until weaning. At young adult age (P60), POE and saline exposed offspring underwent in vivo MRI included diffusion tensor imaging and functional MRI (fMRI). Results indicate that fractional anisotropy (FA) was decreased in adult animals with POE [n = 11] compared to animals that received saline [n = 9] in major white matter tracts, including the corpus callosum (p < 0.001) and external capsule (p < 0.01). This change in FA was concomitant with reduced axial diffusivity in the external capsule (p < 0.01) and increased radial diffusivity in the corpus callosum (p < 0.01). fMRI analyses reveal brainwide FC was diffusely lower in POE (p < 10−6; 10% of variance explained by group). Decreased connectivity in cortical-cortical and cortico-basal ganglia circuitry was particularly prominent with large effect sizes (Glass's Δ > 1). Taken together, these data confirm POE reduces brainwide functional connectivity as well as microstructural integrity of major white matter tracts. Altered neural circuitry, dysregulated network refinement, and diffuse network dysfunction have been implicated in executive function deficits that are common in children with POE. FC may serve as a translatable biomarker in children with POE.

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“… 8 , 9 , 10 Opioids commonly used for pain management can cause neonatal abstinence syndrome and other negative outcomes in the newborns when administered during pregnancy. 11 To date, use of recently approved disease-modifying therapies, such as L-glutamine, crizanlizumab, and voxelotor, 12 has not been investigated during pregnancy. With regard to prophylactic transfusion therapy, the strongest data supporting its use for pregnant people with SCD is a meta-analysis of 1291 individuals; the aforementioned study showed that prophylactic transfusions reduced the frequency of acute pain episodes, maternal and fetal/neonatal mortality, pulmonary embolism, pyelonephritis, and preterm birth.…”

Section: Introductionmentioning

confidence: 99%

Managing sickle cell disease and related complications in pregnancy: results of an international Delphi panel

Sharma,

Kozanoğlu,

Ataga

et al. 2024

Blood Advances

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Data to guide evidence-based management of pregnant people with sickle cell disease (SCD) is limited. This international Delphi panel aimed to identify consensus among multidisciplinary experts for SCD management during pregnancy. The two-round Delphi process used questionnaires exploring seven topics (antenatal care, hydroxyurea use, transfusion, prevention of complications, treatment of complications, delivery and follow-up, and bottlenecks and knowledge gaps) developed by a steering committee. Thirteen panelists (hematologists, physiologists, obstetricians, maternal fetal medicine and transfusion medicine physicians) from the US, the UK, Turkey and France completed the first survey; 12 panelists completed the second round. Anonymized responses were collected and summarized by a contract research organization (Akkodis Belgium). Consensus/strong consensus was predefined as 75%-90% (9-10/12)/>90% (≥11/12) of panelists agreeing or disagreeing on a response to a predefined clinical scenario or statement. In several areas of SCD management, consensus was achieved: experts recommended performing at least monthly multidisciplinary antenatal follow-up, administering prophylactic aspirin for preeclampsia prevention between gestational weeks 12-36, initiating prophylactic transfusion therapy in certain cases, or choosing automated red blood cell exchange over other transfusion methods in patients with iron overload or severe acute chest syndrome. No consensus was reached on several topics including the prophylactic aspirin dose, indications for starting infection prophylaxis, routine use of prophylactic transfusions, or use of prophylactic transfusions for preventing fetal complications. These recommendations could inform clinical care for pregnant SCD patients in the absence of large clinical trials involving this population; the identified knowledge gaps can orient future research.

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Impact of in utero opioid exposure on newborn outcomes: beyond neonatal opioid withdrawal syndrome

Cited by 10 publications

References 30 publications

Perinatal substance use disorder: Examining the impact on adverse pregnancy outcomes

Perinatal substance use disorder: Examining the impact on adverse pregnancy outcomes

In utero methadone exposure permanently alters anatomical and functional connectivity: A preclinical evaluation

Managing sickle cell disease and related complications in pregnancy: results of an international Delphi panel

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