Opiate withdrawal in the infant

Barr, Gordon A.; Jones, Kathy L.

doi:10.1016/0892-0362(94)90121-x

Cited by 19 publications

(12 citation statements)

References 85 publications

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“…These divergent findings have been used to argue for either weaning pregnant women to a low methadone maintenance dose14 15 17 to attempt complete maternal detoxification during pregnancy,16 or for maintaining the maternal methadone dose throughout the pregnancy to avoid fetal distress and death associated with maternal detoxification and withdrawal 411 18 19 The medical management of pregnant women addicted to opiates remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Hyperphagia in neonates withdrawing from methadone

Martinez

Kastner

Taeusch

1999

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Aims-To examine whether hyperphagia is a clinically significant problem in infants born to women receiving methadone maintenance. Methods-The volume of feeds, changes in infant body weight, as well as occurrence of adverse clinical eVects in infants withdrawing from methadone were studied during the first month of life. A retrospective chart review was conducted for all infants at San Francisco General between 1992 and 1995, born to women receiving methadone maintenance during their pregnancy. Forty four infants were identified and the data obtained from hospital medical records. The daily oral intake of these infants was recorded during the first month of life. The incidence of hyperphagia (oral intake > 190 cc/kg/day) was measured. Associations between infant oral intake and maternal methadone dose were studied using correlation analysis as well as Anova for repeated measures. Adverse clinical symptoms were also recorded. A subset of premature infants was studied separately. Results-The incidence of hyperphagia was 26% by day 8 and 56% by day 16 of life in the infants. Hyperphagia was not associated with maternal methadone dose or with infant withdrawal scores. Infants who were hyperphagic lost significantly more weight during the first week of life than those who were not. Despite significantly greater intake, the hyperphagic infants did not gain weight more rapidly during the first month of life compared with those infants with lower oral intake. Infants who were hyperphagic (maximum intake of 290 cc/kg/day) did not experience increased vomiting, aspiration, diarrhoea, or abdominal distention. Conclusions-Hyperphagia is commonly found in infants withdrawing from methadone and can be persistent in a significant number. Hyperphagia was not associated with either increased neonatal weight gain or with adverse gastrointestinal consequences. Hyperphagia may occur in infants withdrawing from methadone who have high metabolic demands due to clinical signs not controlled by opiate treatment. (Arch Dis Child Fetal Neonatal Ed 1999;80:F178-F182)

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Section: Discussionmentioning

confidence: 99%

Hyperphagia in neonates withdrawing from methadone

Martinez

Kastner

Taeusch

1999

Archives of Disease in Childhood - Fetal and Neonatal Edition

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“…NAS is characterized by disturbances in the central and autonomic nervous systems that result in hyperexcitability, high-pitched cry, tremor, diarrhea, tachypnea, feeding intolerance, and, in severe cases, seizures (Barr and Jones 1994;Blinick et al 1976; Dashe et al 2002;Kaltenbach and Finnegan 1992;Suresh and Anand 1998). Furthermore, opiate-exposed infants have an increased incidence of sudden infant death syndrome (Finnegan 1991;Kandall et al 1993;Ward et al 1986).…”

Section: Opiate Exposure In Neonatesmentioning

confidence: 97%

Neonatal Animal Models of Opiate Withdrawal

Richardson¹,

Yohay²,

Gauda³

et al. 2006

ILAR Journal

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The symptoms of opiate withdrawal in infants are defined as neonatal abstinence syndrome (NAS). NAS is a significant cause of morbidity in term and preterm infants. Factors, such as polysubstance abuse, inadequate prenatal care, nutritional deprivation, and the biology of the developing central nervous system contribute to the challenge of evaluating and treating opiate-induced alterations in the newborn. Although research on the effects of opiates in neonatal animal models is limited, the data from adult animal models have greatly contributed to understanding and treating opiate tolerance, addiction, and withdrawal in adult humans. Yet the limited neonatal data that are available indicate that the mechanisms involved in these processes in the newborn differ from those in adult animals, and that neonatal models of opiate withdrawal are needed to understand and develop effective treatment regimens for NAS. In this review, the behavioral and neurochemical evidence from the literature is presented and suggests that mechanisms responsible for opiate tolerance, dependence, and withdrawal differ between adult and neonatal models. Also reviewed are studies that have used neonatal rodent models, the authors' preliminary data based on the use of neonatal rat and mouse models of opiate withdrawal, and other neonatal models that have been proposed for the study of neonatal opiate withdrawal.

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“…These human infants, born to mothers who are exposed to opiate drugs such as heroin during their pregnancy, have a higher incidence of morbidity and mortality than do the offspring of nonaddicted women (Naeye et al 1973;Connaughton et al 1977;Wilson et al 1979). Although there is much research on opiate withdrawal in adult animals, there are few studies in the neonates (Barr and Jones 1994). Recent studies have shown that when the behavioral repertoire appropriate to the age of the animal is examined, infant rat pups experience opiate tolerance and dependence if the dams are exposed to opiates during their pregnancy or the pups are treated directly with opiates (Jones and Barr 1995;Windh et al 1995;; Barr et al 1998).…”

Section: Introductionmentioning

confidence: 98%