Neonatal Outcomes after Combined Opioid and Nicotine Exposure in Utero: A Scoping Review

Isaacs, Krystyna R.; Atreyapurapu, Sravanthi; Alyusuf, Amal; Ledgerwood, David M.; Finnegan, Loretta P.; Chang, Katie; Ma, Tony X.; Washio, Yukiko

doi:10.3390/ijerph181910215

Cited by 7 publications

(5 citation statements)

References 66 publications

(91 reference statements)

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“…Notwithstanding the evidenced gestational consumption of psychoactive drugs in this examined cohort, no significant correlations were found between neonatal outcomes, mothers’ hair results, and interview answers. This is in contrast with previous studies showing a correlation between gestational consumption of tobacco and drugs of abuse and increased risk of spontaneous abortions, reduction in neonatal birth weight and birth length, newborn head circumference, and signs of a more severe neonatal abstinence syndrome [ 27 , 35 , 36 , 37 , 38 ]. It can be hypothesized that in this examined cohort, psychoactive drugs consumption during pregnancy was sporadic and, even if identifiable by hair testing, did not affect offspring features.…”

Section: Discussioncontrasting

confidence: 99%

Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women

Gómez-Ruiz

Marchei²,

Rotolo³

et al. 2022

Pharmaceuticals

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For the first time, the present study employed hair testing to investigate the prevalence of classical drugs of abuse and new psychoactive substances use during gestation in a cohort of 300 Mexican pregnant women. An interview was conducted to collect data on sociodemographic aspects of the patients, and a 9 cm-long hair strand was taken from the back of the head of each mother one month after delivery. A validated ultra-high-performance liquid chromatography–high-resolution mass spectrometry method was used for the screening of classic drugs, new psychoactive substances, and medications in maternal hair. Out of 300 examined hair samples from pregnant women, 127 (42.3%) resulted positive for psychoactive substances: 45 (35.4%) for cannabis only, 24 (18.9%) for methamphetamine only, 13 (10.2%) for cocaine only, 1 (0.3%) for heroin, 1 for N-N-dimethyltryptamine (0.3%), 1 for ketamine (0.8%), and 35 (16.3%) for more than one psychoactive substance. Furthermore, seven samples (2.3%) resulted positive for new psychoactive substances (NPS): two samples for synthetic cannabinoids, two for synthetic cathinones, and three for nor-fentanyl, and 3.3% of women hair resulted positive for anticonvulsant, antidepressant, and antipsychotic medications. Finally, 83 women hair samples (27.7%) tested positive for nicotine. Nonsteroidal anti-inflammatory drugs (NSAIDs) and other painkillers (60.0%), medications for the treatment of nausea and vomiting (12.3%), antihistamines (8.7%) and nasal/sinus decongestants (6.7%), cough suppressants (5.0%), and bronchodilator agents (5.0%) were also detected in pregnant women hair. The gestational use of psychoactive substances and exposure to tobacco smoke, assessed by hair testing, were associated with a significantly younger age and with a low education grade of the mothers (p < 0.005). This study provides a significant preliminary indication of the under-reported gestational consumption of licit and illicit psychoactive and pharmacologically active drugs in a Mexican environment, showing the value of toxicological and forensic analyses in the global effort to determine the health risks caused by classic drugs and new psychoactive substances during pregnancy.

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Section: Discussioncontrasting

confidence: 99%

Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women

Gómez-Ruiz

Marchei²,

Rotolo³

et al. 2022

Pharmaceuticals

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“…However, the analysis of the complete live birth dataset revealed a clear trend toward lower birth weight, especially in the case of older and less educated mothers. We could not adjust the findings for smoking and antenatal care, both of which were associated with adverse neonatal outcomes [24,44]. Unfortunately, these data were missing in the birth card registry and were therefore excluded from the analysis.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Inequalities in Birth Weight in Relation to Maternal Factors: A Population-Based Study of 3,813,757 Live Births

Genowska

Motkowski

Strukčinskaitė

et al. 2022

IJERPH

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Background: Despite numerous studies of women having children later in life, evidence of the relationship between maternal factors and newborn outcomes in Central and Eastern European countries is limited. This study aimed to examine the association between maternal age, biological determinants, including parity and sex of the newborn, demographic and social background, and birth weight in 3.8 million singleton live births in Poland. Methods: The effect of maternal age on birth weight (in grams and Z-scores) adjusted for confounders was assessed using Generalized Linear Models. Results: The mean (±SD) birth weights of neonates born to primiparous women and multiparous women were 3356.3 ± 524.9 g and 3422.7 ± 538.6 g, respectively, which corresponded to a Z-score of −0.07 ± 0.96 and 0.14 ± 1.00, respectively (p ≤ 0.001). After controlling for biological, demographic, and social factors, a significant decrease in birth weight was found for primiparous women of the age group ≥30 years and multiparous women aged ≥35 years compared to the age group of 25–29 years. The lowest neonatal birth weight was observed in the case of women aged ≥45 years. Confounders did not affect birth weight Z-scores among primiparous women, whereas among multiparous women, together with educational factors, they reversed Z-scores from positive to negative values. The lower birth weight of neonates was overall associated with lower maternal education. Conclusions: Regardless of parity, advanced maternal age is strongly associated with a decreased neonatal birth weight, implying complications in early pregnancy and the antenatal period as well as obstetric complications. Counseling to support women’s family planning decisions and improving women’s education during their reproductive age may help to alleviate unfavorable newborn outcomes.

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“…47 It is important to consider given its potential influence on low birth weight, preterm birth, and congenital anomalies 48 and that tobacco may interact with other substances to increase risk for adverse neonatal outcomes. 49 Future research may explore specific service offerings, patterns of engagement, and their impact on neonatal outcomes. As detailed in Urbanoski et al, 23 integrated treatment programs provided more services, on average, than treatment programs; however, standard treatment programs may have attended to similar presenting needs of women (e.g., support and coordination with child protection services, social service referrals and navigation support (e.g., housing, food, and income support), and mental health counseling).…”

Section: Researchmentioning

confidence: 99%

“…Prior work has suggested that tobacco use is less likely to change during pregnancy compared with other substances 47 . It is important to consider given its potential influence on low birth weight, preterm birth, and congenital anomalies 48 and that tobacco may interact with other substances to increase risk for adverse neonatal outcomes 49 …”

Section: Limitations and Future Researchmentioning

confidence: 99%

Neonatal outcomes of pregnant women attending integrated and standard substance use treatment programs in Ontario, Canada

Milligan,

Tarasoff,

Rodrigues

et al. 2023

Birth

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BackgroundSubstance use in pregnancy raises concern given its potential teratogenic effects. Given the unique needs of parenting people and the potential impact for developing children, specialized substance use treatment programs are increasingly being implemented for this population. Substance use treatment is associated with more positive neonatal outcomes compared with no treatment, however treatment models vary limiting our understanding of key treatment components/modelsFew studies have explored the influence of treatment model type (i.e., integrated treatments designed for pregnant clients compared with standard treatment models) and no studies have examined the influence of treatment model on neonatal outcomes using Canadian data.MethodWe conducted a population‐based cohort study of clients who were pregnant when initiating integrated (n = 564) and standard (n = 320) substance use treatment programs in Ontario, Canada.ResultsNeonatal outcomes did not significantly differ by treatment type (integrated or standard), with rates of adverse neonatal outcomes higher than published rates for the general population, despite receipt of adequate levels of prenatal care. While this suggests no significant impact of treatment, it is notable that as a group, clients engaged in integrated treatment presented with more risk factors for adverse neonatal outcomes than those in standard treatment. While we controlled for these risks in our analyses, this may have obscured their influence in relation to treatment type.ConclusionFindings underscore the need for more nuanced research that considers the influence of client factors in interaction with treatment type. Pregnant clients engaged in any form of substance use treatment are at higher risk of having children who experience adverse neonatal outcomes. This underscores the urgent need for further investment in services and research to support maternal and neonatal health before and during pregnancy, as well as long‐term service models that support women and children beyond the perinatal and early childhood periods.

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Neonatal Outcomes after Combined Opioid and Nicotine Exposure in Utero: A Scoping Review

Cited by 7 publications

References 66 publications

Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women

Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women

Inequalities in Birth Weight in Relation to Maternal Factors: A Population-Based Study of 3,813,757 Live Births

Neonatal outcomes of pregnant women attending integrated and standard substance use treatment programs in Ontario, Canada

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