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Pregnancy substance use disorder

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https://www.readbyqxmd.com/read/28414486/girls-with-childhood-adhd-as-adults-cross-domain-outcomes-by-diagnostic-persistence
#1
Elizabeth B Owens, Christine Zalecki, Peter Gillette, Stephen P Hinshaw
OBJECTIVE: To ascertain adult outcomes in 10 domains reflecting symptomatology (internalizing, externalizing, self-injury, substance use), attainment (education, employment), and impairment (health, social, driving, overall) as a function of both childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) and persistence of ADHD symptoms across time. METHOD: We prospectively followed 140 grade-school-aged girls with rigorously diagnosed childhood ADHD and 88 age- and ethnicity-matched comparison girls for 16 years...
April 17, 2017: Journal of Consulting and Clinical Psychology
https://www.readbyqxmd.com/read/28406856/treating-women-who-are-pregnant-and-parenting-for-opioid-use-disorder-and-the-concurrent-care-of-their-infants-and-children-literature-review-to-support-national-guidance
#2
Stacey L Klaman, Krystyna Isaacs, Anne Leopold, Joseph Perpich, Susan Hayashi, Jeff Vender, Melinda Campopiano, Hendrée E Jones
OBJECTIVES: The prevalence of opioid use disorder (OUD) during pregnancy is increasing. Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child. This article summarizes the literature review conducted using the RAND/University of California, Los Angeles Appropriateness Method project completed by the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration to obtain current evidence on treatment approaches for pregnant and parenting women with OUD and their infants and children...
April 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28406855/beyond-the-treatment-box-perspectives-on-the-federal-response-to-opioid-use-pregnancy-and-neonatal-abstinence-syndrome
#3
Mishka Terplan
There has been much activity within Federal agencies in response to the opioid epidemic particularly in regards to pregnant women and their infants. Substance Abuse and Mental Health Services Administration's recently released document, Advancing the Care of Pregnant and Parenting Women With Opioid Use Disorder and Their Infants: A Foundation for Clinical Guidance, provides an important and timely guidance. Uptake of the guide should improve quality of care and hopefully help lessen the discrimination experienced by pregnant women with opioid use disorder...
April 13, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28403463/facilitators-and-barriers-to-cigarette-smoking-while-pregnant-for-women-with-substance-use-disorders
#4
Shauna P Acquavita, Alexandra Talks, Kayleigh Fiser
Introduction: Cigarette smoking among pregnant women diagnosed with substance use disorders (SUD) is four times higher than smoking among pregnant women without SUD. However, much of the literature on pregnancy and smoking has centered on the latter group. This study used the Health Belief Model as a framework to explore smoking cessation in pregnant women with SUD. Methods: Four 60-minute focus groups were conducted with a semistructured moderator guide. Participants (N = 21) were women who smoked during pregnancy, gave birth within the past year, and were residing at a women's SUD treatment center...
May 1, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28387979/prescription-contraception-use-and-adherence-by-women-with-substance-use-disorders
#5
Gillian Griffith, Tara Kumaraswami, Stavroula A Chrysanthopoulou, Kristin M Mattocks, Robin E Clark
BACKGROUND AND AIMS: Unintended pregnancy rates are high among women with substance use disorders (SUDs), which could be partly explained by lower use of and adherence to contraception. We aimed to test: (1) the association of SUD with prescription contraceptive use, contraceptive method selection, and adherence; (2) whether practices participating in the Patient-Centered Medical Home Initiative (PCMHI) had better contraceptive use and adherence for patients with SUD; (3) for differences in the association of SUD with adherence by type of contraceptive used...
April 7, 2017: Addiction
https://www.readbyqxmd.com/read/28363609/maternal-fetal-monitoring-of-opioid-exposed-pregnancies-analysis-of-a-pilot-community-based-protocol-and-review-of-the-literature
#6
Gareth Ryan, Joe Dooley, Rory Windrim, Megan Bollinger, Lianne Gerber Finn, Len Kelly
OBJECTIVES: To describe/analyse a novel, community-based prenatal monitoring protocol for opioid-exposed pregnancies developed by our centre in 2014 to optimize prenatal care for this population. A literature review of published monitoring protocols for this population is also presented. METHODS: Retrospective comparison of pre-protocol (n = 215) and post-protocol (n = 251) cohorts. Medline and Embase were searched between 2000-2016 using MeSH terms: [fetal monitoring OR prenatal care] AND [opioid-related disorders OR substance-related disorders] in Medline and [fetal monitoring OR prenatal care] AND [opiate addiction OR substance abuse] in Embase, producing 518 results...
March 28, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28291588/discharge-against-medical-advice-in-the-united-states-2002-2011
#7
Kiara K Spooner, Jason L Salemi, Hamisu M Salihu, Roger J Zoorob
OBJECTIVE: To describe the national frequency, prevalence, and trends of discharge against medical advice (DAMA) among inpatient hospitalizations in the United States and identify differences across patient- and hospital-level characteristics, overall and in clinically distinct diagnostic subgroups. PATIENTS AND METHODS: We conducted a retrospective, cross-sectional analysis of inpatient hospitalizations (≥18 years), discharged between January 1, 2002, and December 31, 2011, using the Nationwide Inpatient Sample...
March 10, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28278146/cdc-grand-rounds-public-health-strategies-to-prevent-neonatal-abstinence-syndrome
#8
Jean Y Ko, Sara Wolicki, Wanda D Barfield, Stephen W Patrick, Cheryl S Broussard, Kimberly A Yonkers, Rebecca Naimon, John Iskander
Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome that most commonly occurs in infants after in utero exposure to opioids, although other substances have also been associated with the syndrome (1). NAS usually appears within 48-72 hours of birth with a constellation of clinical signs, including central nervous system irritability (e.g., tremors), gastrointestinal dysfunction (e.g., feeding difficulties), and temperature instability (1) (Box 1). Opioid exposure during pregnancy might result from clinician-approved use of prescription opioids for pain relief; misuse or abuse of prescription opioids; illicit use (e...
March 10, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28270105/economic-evaluation-of-a-behavioral-intervention-versus-brief-advice-for-substance-use-treatment-in-pregnant-women-results-from-a-randomized-controlled-trial
#9
Xiao Xu, Kimberly A Yonkers, Jennifer Prah Ruger
BACKGROUND: Substance use in pregnancy is associated with severe maternal and fetal morbidities and substantial economic costs. However, few studies have evaluated the cost-effectiveness of substance use treatment programs in pregnant women. The purpose of this study was to evaluate the economic impact of a behavioral intervention that integrated motivational enhancement therapy with cognitive behavioral therapy (MET-CBT) for treatment of substance use in pregnancy, in comparison with brief advice...
March 7, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28219965/a-public-health-response-to-opioid-use-in-pregnancy
#10
Stephen W Patrick, Davida M Schiff
The use of opioids during pregnancy has grown rapidly in the past decade. As opioid use during pregnancy increased, so did complications from their use, including neonatal abstinence syndrome. Several state governments responded to this increase by prosecuting and incarcerating pregnant women with substance use disorders; however, this approach has no proven benefits for maternal or infant health and may lead to avoidance of prenatal care and a decreased willingness to engage in substance use disorder treatment programs...
February 20, 2017: Pediatrics
https://www.readbyqxmd.com/read/28188773/maternal-buprenorphine-treatment-and-fetal-neurobehavioral-development
#11
Lauren M Jansson, Martha Velez, Krystle McConnell, Nancy Spencer, Michelle Tuten, Hendree E Jones, Van L King, Neeraj Gandotra, Lorraine A Milio, Kristin Voegtline, Janet A DiPietro
BACKGROUND: Gestational opioid use/misuse is escalating in the United States; however, little is understood about the fetal effects of medications used to treat maternal opioid use disorders. OBJECTIVE: The purpose of this study was to determine the effect of maternal buprenorphine administration on longitudinal fetal neurobehavioral development. STUDY DESIGN: Forty-nine buprenorphine-maintained women who attended a substance use disorder treatment facility with generally uncomplicated pregnancies underwent fetal monitoring for 60 minutes at times of trough and peak maternal buprenorphine levels...
February 7, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28178050/filled-prescriptions-for-opioids-after-vaginal-delivery
#12
Marian Jarlenski, Lisa M Bodnar, Joo Yeon Kim, Julie Donohue, Elizabeth E Krans, Debra L Bogen
OBJECTIVE: To estimate the prevalence of filled opioid prescriptions after vaginal delivery. METHODS: We conducted a retrospective cohort study of 164,720 Medicaid-enrolled women in Pennsylvania who delivered a liveborn neonate vaginally from 2008 to 2013, excluding women who used opioids during pregnancy or who had an opioid use disorder. We assessed overall filled prescriptions as well as filled prescriptions in the presence or absence of the following pain-inducing conditions: bilateral tubal ligation, perineal laceration, or episiotomy...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28160896/patient-centered-care-to-address-barriers-for-pregnant-women-with-opioid-dependence
#13
REVIEW
Mary Beth Sutter, Sarah Gopman, Lawrence Leeman
Pregnant women affected by substance use often encounter barriers to treatment, including housing insecurity, poverty, mental health issues, social stigma, and access to health care. Providers may lack the resources needed to provide quality care. Clinicians offering prenatal care to women with substance use disorder are encouraged to support family-centered, multidisciplinary care to women and their infants, focusing on harm reduction. Collaboration between providers of maternity care, substance abuse treatment, case management, family primary care, and pediatric developmental care can improve outcomes during pregnancy and through the early years of parenting...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28129942/characterization-of-u-s-state-laws-requiring-health-care-provider-reporting-of-perinatal-substance-use
#14
Marian Jarlenski, Caroline Hogan, Debra L Bogen, Judy C Chang, Lisa M Bodnar, Elizabeth Van Nostrand
BACKGROUND: State policies pertaining to health care provider reporting of perinatal substance use have implications for provider screening and referral behavior, patients' care seeking and access to prenatal substance use disorder treatment, and pregnancy and birth outcomes. OBJECTIVES: This study sought to characterize specific provisions enacted in state statutes pertaining to mandates that health care providers report perinatal substance use, and to determine the proportion of births occurring in states with such laws...
January 24, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28107153/human-trafficking-mental-illness-and-addiction-avoiding-diagnostic-overshadowing
#15
Hanni Stoklosa, Marti MacGibbon, Joseph Stoklosa
This article reviews an emergency department-based clinical vignette of a trafficked patient with co-occurring pregnancy-related, mental health, and substance use disorder issues. The authors, including a survivor of human trafficking, draw on their backgrounds in addiction care, human trafficking, emergency medicine, and psychiatry to review the literature on relevant general health and mental health consequences of trafficking and propose an approach to the clinical complexities this case presents. In their discussion, the authors explicate the deleterious role of implicit bias and diagnostic overshadowing in trafficked patients with co-occurring addiction and mental illness...
January 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/27940055/the-effects-of-sildenafil-citrate-on-uterine-angiogenic-status-and-serum-inflammatory-markers-in-an-l-name-rat-model-of-pre-eclampsia
#16
Nerolen Soobryan, Saravanakumar Murugesan, Wendy Phoswa, Prem Gathiram, Jagidesa Moodley, Irene Mackraj
Pre-eclampsia (PE), a hypertensive disorder of pregnancy, is detrimental to both mother and foetus. There is currently no effective treatment, but we have shown that Sildenafil Citrate (SC) improve various foetal outcomes in N(ω)-nitro-L arginine methyl ester (L-NAME) rat model of PE. Therefore, we aimed to investigate the effects of SC on a uterine angiogenic status and serum inflammatory markers in an L-NAME rat model of PE. One hundred and twenty adult nulliparous pregnant female Sprague-Dawley rats were used for the study...
December 7, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27915237/placental-morphology-in-fetal-alcohol-spectrum-disorders
#17
Marlene Tai, Anna Piskorski, Jennifer C W Kao, Lynn A Hess, Suzanne M de la Monte, Füsun Gündoğan
AIMS: Maternal alcohol drinking adversely affects pregnancy outcome. Although fetal health and development are highly dependent upon the integrity of placentation, little is known about placental morphology following gestational exposure to alcohol in humans. METHODS: In this clinical study, subjects were recruited between 2010 and 2013 from an outpatient substance abuse and mental health treatment center for women. Data collected included maternal age, substance abuse history, comorbidities, pregnancy outcomes, gestational age at delivery, birth weight and placental weight...
December 3, 2016: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/27824771/maternal-deaths-from-suicide-and-overdose-in-colorado-2004-2012
#18
Torri D Metz, Polina Rovner, M Camille Hoffman, Amanda A Allshouse, Krista M Beckwith, Ingrid A Binswanger
OBJECTIVE: To ascertain demographic and clinical characteristics of maternal deaths from self-harm (accidental overdose or suicide) to identify opportunities for prevention. METHODS: We report a case series of pregnancy-associated deaths resulting from self-harm in the state of Colorado between 2004 and 2012. Self-harm deaths were identified from several sources, including death certificates. Birth and death certificates along with coroner, prenatal care, and delivery hospitalization records were abstracted...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27807736/-analgesic-drugs-during-pregnancy
#19
S Hultzsch, C Schaefer
Some important limitations must be taken into consideration for analgesic therapy during pregnancy. Paracetamol is the agent of choice for mild to moderate pain in any stage of pregnancy. Ibuprofen is the non-steroidal anti-inflammatory drug (NSAID) of choice; however, these substances are contraindicated after 28 weeks of gestation due to the increasing risk of premature closure of the ductus arteriosus and impairment of fetal kidney function. Even opioids can be used for severe pain but peripartum administration can lead to neonatal respiratory depression and adaptation disorders and long-term therapy up to the end of pregnancy can lead to neonatal withdrawal symptoms...
December 2016: Der Schmerz
https://www.readbyqxmd.com/read/27773527/a-moral-or-medical-problem-the-relationship-between-legal-penalties-and-treatment-practices-for-opioid-use-disorders-in-pregnant-women
#20
Cara Angelotta, Carol J Weiss, John W Angelotta, Richard A Friedman
OBJECTIVE: The relationship between use of medication-assisted treatment (MAT) in pregnant women with opioid use disorders, the standard of care, and state laws that permit child abuse charges for illicit drug use during pregnancy has not been described. METHODS: Using publicly available data on substance abuse treatment in the United States, we describe patterns in the use of MAT for pregnant women with opioid use disorders in states with prenatal child abuse laws compared with states without such laws...
October 20, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
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