Narcotic Addiction in Pregnancy with Adverse Maternal and Perinatal Outcome

Lam, S. K.; To, William W. K.; Duthie, S. J.; K., H.

doi:10.1111/j.1479-828x.1992.tb01950.x

Cited by 70 publications

(37 citation statements)

References 11 publications

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“…Similar to the case-control studies, many (17 of 33) of the cohort studies were published before 1999 18,21,24,25,41,45,47,51,53,56,63,74,76,78,85,86,88 Methadone and heroin were the most common opioid exposures evaluated, with methadone maintenance treatment (MMT) as the most common indication for methadone exposure. Ten studies did not calculate risk estimates of congenital malformations in infants exposed to opioids, 13,24,41,45,51,74,80,81,85,85 and in 5 studies, no congenital malformations were reported in any infant.…”

Section: Resultsmentioning

confidence: 99%

Maternal Use of Opioids During Pregnancy and Congenital Malformations: A Systematic Review

et al. 2017

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CONTEXT Opioid use and abuse have increased dramatically in recent years, particularly among women. OBJECTIVES We conducted a systematic review to evaluate the association between prenatal opioid use and congenital malformations. DATA SOURCES We searched Medline and Embase for studies published from 1946 to 2016 and reviewed reference lists to identify additional relevant studies. STUDY SELECTION We included studies that were full-text journal articles and reported the results of original epidemiologic research on prenatal opioid exposure and congenital malformations. We assessed study eligibility in multiple phases using a standardized, duplicate review process. DATA EXTRACTION Data on study characteristics, opioid exposure, timing of exposure during pregnancy, congenital malformations (collectively or as individual subtypes), length of follow-up, and main findings were extracted from eligible studies. RESULTS Of the 68 studies that met our inclusion criteria, 46 had an unexposed comparison group; of those, 30 performed statistical tests to measure associations between maternal opioid use during pregnancy and congenital malformations. Seventeen of these (10 of 12 case-control and 7 of 18 cohort studies) documented statistically significant positive associations. Among the case-control studies, associations with oral clefts and ventricular septal defects/atrial septal defects were the most frequently reported specific malformations. Among the cohort studies, clubfoot was the most frequently reported specific malformation. LIMITATIONS Variabilities in study design, poor study quality, and weaknesses with outcome and exposure measurement. CONCLUSIONS Uncertainty remains regarding the teratogenicity of opioids; a careful assessment of risks and benefits is warranted when considering opioid treatment for women of reproductive age.

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Section: Resultsmentioning

confidence: 99%

Maternal Use of Opioids During Pregnancy and Congenital Malformations: A Systematic Review

et al. 2017

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“…The incidence of stillbirths and neonatal mortality in addicts is 2-4 times higher than that in the general population (Lam et al, 1992). Moreover, sudden infant death syndrome is seven times more frequent in the children of addicts than in the normal population.…”

Section: Human Studiesmentioning

confidence: 91%

“…The principal causes of infant death are prematurity and growth retardation (Bashore et al, 1981). In a Chinese population, babies born to drug-addicted mothers were on average 629 g lighter at birth, 5 cm smaller in head circumference and 7 cm shorter in body length (Lam et al, 1992). Adverse consequences are associated with many incremental social, psychosocial and contextual factors, such as a chaotic lifestyle, incomplete nutrition, intrauterine infections and inadequate prenatal care (Schempf, 2007).…”

Section: Human Studiesmentioning

confidence: 99%

Behavioral effects of perinatal opioid exposure

2014

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“…Others have suggested that the variation in risk of IUGR in ODMs may be associated with numerous secondary factors closely linked to opioid addiction. These include increased incidence of maternal infections, reduced attendance at antenatal clinics, poor mental and physical health, domestic violence and any concomitant heroin use 1 4 6 25…”

Section: Commentsmentioning

confidence: 99%

“…In addition, several studies have shown intrauterine growth restriction (IUGR) to be a common feature in pregnancies of opioid-dependent mothers (ODMs) 4–6. IUGR is thought to have significant long-term effects on the risk of adult-onset diseases such as the metabolic syndrome, hypertension and coronary heart disease as well as delayed physical, mental and social development as a child 7 8.…”

mentioning

confidence: 99%