Substance misuse in pregnancy

Association of Maternal Opioid Use in Pregnancy With Adverse Perinatal Outcomes in Ontario, Canada, From 2012 to 2018

“…In pregnancy, women with an opioid use disorder can undergo opioid agonist maintenance treatment to reduce complications in pregnancy associated with withdrawal and improve outcomes in mother-infant dyads. 24,25 Buprenorphine is a potential first-line treatment to improve neonatal outcomes in this population. 23 Compared with methadone-exposed neonates, buprenorphineexposed neonates require less morphine sulfate to treat NAS and have shorter hospital stays.…”

Alcohol, smoking, and other substance use in the perinatal period

“…Smoking during pregnancy is associated with a range of adverse offspring outcomes, including reduced fetal growth 31. It is also associated with an increased risk of miscarriage, prematurity, placental abruption, and stillbirth 31. Provide information about the magnitude of the risk: in 2018 there were four stillbirths per total 1000 births in England and Wales 32.…”

The Effects of opioids on female fertility, pregnancy and the breastfeeding mother‐infant dyad: A Review

“…The rise of prescription opioid medications to treat chronic pain has resulted in an epidemic of drug dependency and overdose deaths in the United States and Canada 1,2 . Over the past decade in Canada, rates of opioid overdose‐related hospitalization have increased by more than 50%, from 10.2 to 15.6 per 100 000.…”

“…In pregnancy, women with an opioid use disorder may be managed by opioid agonist maintenance treatment (OAMT). This strategy uses methadone or buprenorphine (buprenorphine/naloxone or mono‐product) to reduce pregnancy complications associated with withdrawal and improve outcomes for mother‐infant dyads 15‐17 . Methadone is a long‐acting competitive mu‐receptor agonist, while buprenorphine is a partial mu‐opioid receptor agonist 2 .…”