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opioids and pregnancy

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https://www.readbyqxmd.com/read/29651928/rural-postpartum-women-with-substance-use-disorders
#1
Debra Kramlich, Rebecca Kronk, Lenora Marcellus, Alison Colbert, Karen Jakub
The incidence of perinatal opioid use and neonatal withdrawal continues to rise rapidly in the face of the growing opioid addiction epidemic in the United States, with rural areas more severely affected. Despite decades of research and development of practice guidelines, maternal and neonatal outcomes have not improved substantially. This focused ethnography sought to understand the experience of accessing care necessary for substance use disorder recovery, pregnancy, and parenting. Personal accounts of 13 rural women, supplemented by participant observation and media artifacts, uncovered three domains with underlying themes: challenges of getting treatment and care (service availability, distance/geographic location, transportation, provider collaboration/coordination, physical and emotional safety), opportunities to bond (proximity, information), and importance of relationships (respect, empathy, familiarity, inclusion, interactions with care providers)...
April 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29643617/comparison-of-ropivacaine-0-2-with-or-without-clonidine-1-%C3%AE-g-kg-for-epidural-labor-analgesia-a-randomized-controlled-study
#2
Indira Kumari, Kapil Sharma, Vikram Bedi, Madhan Mohan, Hemraj Tungaria, Manish Kumar Modi
Background and Aims: The aim is to determine the effect of addition of clonidine to ropivacaine for epidural labor analgesia with regard to onset of analgesia, duration of analgesia, neonatal outcome, and quality of analgesia. Material and Methods: A total of 60 term parturients of the American Society of Anesthesiologists Grade I and II with uncomplicated pregnancy, vertex presentation, posted for on-demand epidural labor analgesia after informed consent were divided in two groups...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29630018/prescription-and-other-medication-use-in-pregnancy
#3
David M Haas, Derek J Marsh, Danny T Dang, Corette B Parker, Deborah A Wing, Hyagriv N Simhan, William A Grobman, Brian M Mercer, Robert M Silver, Matthew K Hoffman, Samuel Parry, Jay D Iams, Steve N Caritis, Ronald J Wapner, M Sean Esplin, Michal A Elovitz, Alan M Peaceman, Judith Chung, George R Saade, Uma M Reddy
OBJECTIVE: To characterize prescription and other medication use in a geographically and ethnically diverse cohort of women in their first pregnancy. METHODS: In a prospective, longitudinal cohort study of nulliparous women followed through pregnancy from the first trimester, medication use was chronicled longitudinally throughout pregnancy. Structured questions and aids were used to capture all medications taken as well as reasons they were taken. Total counts of all medications taken including number in each category and class were captured...
April 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29630016/opioid-detoxification-during-pregnancy-a-systematic-review
#4
Mishka Terplan, Hollis J Laird, Dennis J Hand, Tricia E Wright, Ashish Premkumar, Caitlin E Martin, Marjorie C Meyer, Hendrée E Jones, Elizabeth E Krans
OBJECTIVE: To systematically review maternal and neonatal outcomes associated with opioid detoxification during pregnancy. DATA SOURCES: PubMed, PsycINFO, EMBASE, Cochrane, and ClinicalTrials.gov databases were searched from January 1, 1966, to September 1, 2016. METHODS OF STUDY SELECTION: English-language studies that reported outcomes associated with opioid detoxification among pregnant women with opioid use disorder were included. Nonoriginal research articles (case reports, editorials, reviews) and studies that failed to report outcomes for detoxification participants were excluded...
April 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29610676/pregnant-or-recently-pregnant-opioid-users-contraception-decisions-perceptions-and-preferences
#5
Rebecca L Fischbein, Bethany G Lanese, Lynn Falletta, Kelsey Hamilton, Jennifer A King, Deric R Kenne
Background: Multiple factors are linked to extremely high unintended pregnancy rates among women who use opioids, including various barriers to contraception adherence. These include patient level barriers such as lack of knowledge and education about highly effective contraception, and potential provider barriers. Using a mixed-methods framework to examine the contraception-related perceptions and preferences of opioid using women is a necessary next step to understanding this phenomenon...
2018: Contraception and reproductive medicine
https://www.readbyqxmd.com/read/29601303/the-opioid-epidemic-and-pregnancy-implications-for-anesthetic-care
#6
Britany L Raymond, Bradley T Kook, Michael G Richardson
PURPOSE OF REVIEW: This review summarizes evolving knowledge regarding adverse maternal, fetal, and neonatal effects of opioid exposure during pregnancy, and current treatment options for opioid use disorder (OUD). Maternal and fetal implications of maternal opioid maintenance with methadone and buprenorphine are described. Finally, acute and chronic pain management strategies in opioid-tolerant parturients are reviewed. RECENT FINDINGS: Opioid use among parturients has risen dramatically, with opioid use during pregnancy as high as 20%...
March 29, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29580450/opioid-utilization-by-pregnant-women-with-sickle-cell-disease-and-the-risk-of-neonatal-abstinence-syndrome
#7
Aisha Nnoli, Neil S Seligman, Kevin Dysart, Jason K Baxter, Samir K Ballas
BACKGROUND: Pregnant women with sickle cell disease (SCD) are at increased risk of maternal and fetal complications. There are limited data on the outcome of the treatment of VOCs with opioids in relation to neonatal complications during pregnancy. METHODS: This is a retrospective cohort study of women with SCD from January 1999 to December 2008. Women with SCD were identified by ICD-9 codes and matched 2:1 to a control group of women on methadone for opioid dependence...
April 2018: Journal of the National Medical Association
https://www.readbyqxmd.com/read/29572908/causal-analysis-in-evaluating-complex-health-interventions-identifying-the-optimal-treatment-for-opioid-abuse-in-pregnancy
#8
Courtney D Lynch, Mona R Prasad
No abstract text is available yet for this article.
March 23, 2018: Paediatric and Perinatal Epidemiology
https://www.readbyqxmd.com/read/29572587/neonatal-abstinence-syndrome-nas-in-southwestern-border-states-examining-trends-population-correlates-and-implications-for-policy
#9
Khaleel S Hussaini, Luigi F Garcia Saavedra
Introduction Neonatal abstinence syndrome (NAS) is withdrawal syndrome in newborns following birth and is primarily caused by maternal drug use during pregnancy. This study examines trends, population correlates, and policy implications of NAS in two Southwest border states. Materials and Methods A cross-sectional analysis of Hospital Inpatient Discharge Data (HIDD) was utilized to examine the incidence of NAS in the Southwest border states of Arizona (AZ) and New Mexico (NM). All inpatient hospital births in AZ and NM from January 1, 2008 through December 31, 2013 with ICD9-CM codes for NAS (779...
March 23, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29570477/is-preconception-substance-use-associated-with-unplanned-or-poorly-timed-pregnancy
#10
Lisbet S Lundsberg, Stephanie Peglow, Neena Qasba, Kimberly A Yonkers, Aileen M Gariepy
OBJECTIVE: Unplanned and poorly timed pregnancies are associated with adverse maternal and neonatal outcomes. Further understanding of preconception substance use with unplanned and poorly timed pregnancy is warranted. METHODS: Data were analyzed from a prospective study enrolling women early in pregnancy. Preconception tobacco, alcohol, marijuana, opioid, and cocaine use was ascertained. Participants reported whether their current pregnancy was planned and whether it was a good time to be pregnant...
March 22, 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29547380/maternal-opioid-use-disorder-and-neonatal-abstinence-syndrome-in-northwest-ontario-a-7-year-retrospective-analysis
#11
Joe Dooley, Gareth Ryan, Lianne Gerber Finn, Megan Bollinger, Cai-Lei Matsumoto, Wilma M Hopman, Len Kelly
INTRODUCTION: Opioid use in pregnancy is increasing globally. In northwest Ontario, rates of neonatal abstinence syndrome (NAS) are alarmingly high. We sought to document the increasing rates of opioid exposure during pregnancy and associated cases of NAS over a 7-year period in northwest Ontario. METHODS: We conducted a retrospective chart review at the Sioux Lookout Meno Ya Win Health Centre catchment area (population 29 000) maternity program in northwest Ontario of mother-infant dyads of live births from Jan...
2018: Canadian Journal of Rural Medicine
https://www.readbyqxmd.com/read/29530747/use-of-intravenous-acetaminophen-in-postoperative-pain-management-after-partial-and-full-bony-impacted-third-molar-extractions-a-randomized-double-blind-controlled-trial
#12
Isabel Atencio, Max Beushausen, John J Kowalczyk, Andres Flores-Hidalgo, Nora F Fino, Dale A Baur
PURPOSE: Currently, there is a concern at the national level of the overuse of both prescription and nonprescription opioid use. The purpose of this study was to identify whether the use of the intravenous (IV) formulation of acetaminophen (Ofirmev; Mallinckrodt Pharmaceuticals, Staines-upon-Thames, United Kingdom) is an effective tool in the reduction of postoperative pain, with a secondary goal of reduction of postoperative narcotic use. MATERIALS AND METHODS: A total of 72 patients with previously diagnosed either partial bony or complete bony impacted third molars were selected with care to avoid long-acting local anesthetics or dissociative anesthetic agents...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29527487/hypersynchrony-in-meg-spectral-amplitude-in-prospectively-identified-6-month-old-infants-prenatally-exposed-to-alcohol
#13
Julia M Stephen, Lucinda Flynn, Danielle Kabella, Megan Schendel, Sandra Cano, Daniel D Savage, William Rayburn, Lawrence M Leeman, Jean Lowe, Ludmila N Bakhireva
Early identification of children who experience developmental delays due to prenatal alcohol exposure (PAE) remains a challenge for individuals who do not exhibit facial dysmorphia. It is well-established that children with PAE may still exhibit the cognitive and behavioral difficulties, and individuals without facial dysmorphia make up the majority of individuals affected by PAE. This study employed a prospective cohort design to capture alcohol consumption patterns during pregnancy and then followed the infants to 6 months of age...
2018: NeuroImage: Clinical
https://www.readbyqxmd.com/read/29527296/management-of-eight-labor-and-delivery-patients-dependent-on-buprenorphine-subutex%C3%A2-a-retrospective-chart-review
#14
Solina Tith, Garinder Bining, Laurent Bollag
Background : Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by "The American College of Obstetrics and Gynecology" as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists' unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia...
2018: F1000Research
https://www.readbyqxmd.com/read/29521669/the-use-of-serum-methadone-metabolite-ratios-to-monitor-changing-perinatal-pharmacokinetics
#15
John J McCarthy, Ernest J Vasti, Martin H Leamon, Joseph Graas, Coburn Ward, Catherine Fassbender
OBJECTIVES: Pregnancy profoundly alters drug metabolism, accelerating clearance and confounding medication management, primarily through induction of CYP450 enzymes. Methadone is a CYP450 substrate with altered pharmacokinetics during pregnancy. We report on the use of serum methadone/metabolite ratios (MMRs) to monitor changes in methadone metabolism through the perinatal period and to objectively guide methadone dosing. Previous research found average MMRs in nonpregnant populations of between 11...
March 7, 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29520355/the-epidemic-of-neonatal-abstinence-syndrome-historical-references-of-its-origins-assessment-and-management
#16
REVIEW
Enrique Gomez-Pomar, Loretta P Finnegan
Neonatal abstinence syndrome (NAS) refers to a constellation of signs that are present in some newborn infants resulting from the abrupt cessation of passive transfer of maternal opioids used during pregnancy. The classic NAS refers to infants born to mothers who used opioids during pregnancy, but the term has broadened to include infants whose mothers have used or abused other psychoactive substances during pregnancy that contribute to the expression of the syndrome. Pregnant women who use opioids do so illicitly, and/or as medically prescribed for pain relief, and/or as medication assisted treatment for opioid dependence...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29515226/finding-the-right-treatment-for-neonatal-abstinence-syndrome-is-this-the-right-time
#17
Elizabeth Yen, Jonathan M Davis
Neonatal abstinence syndrome (NAS) is a constellation of withdrawal symptoms in infants born to mothers with chronic opioid use during pregnancy. A proportion of infants will need pharmacotherapy in addition to non-pharmacological interventions. In this article, we reviewed a clinical trial comparing the use of sublingual buprenorphine to oral morphine (the most widely used pharmacotherapy for NAS) in term infants. The primary end point was the duration of treatment, and secondary end points were the length of hospital stay, the proportion of infants who needed supplemental phenobarbital, and safety...
March 7, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29505087/pregnancy-and-the-opioid-epidemic
#18
Amy L Haycraft
Opioid use disorder (OUD) in pregnancy is increasing, which often results in poor maternal and neonatal outcomes including neonatal abstinence syndrome (NAS) as a result of lack of prenatal care and inadequate substance use disorder management. Practice guidelines have been developed to manage OUD during and after pregnancy for mother and baby, but barriers exist, limiting comprehensive implementation. To reduce the impact of OUD in pregnancy and associated maternal and neonatal sequela, implementing compassionate evidence-based care and a non-punitive response is needed...
March 1, 2018: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29500784/hepatitis-c-virus-knowledge-among-pregnant-women-with-opioid-use-disorder
#19
Elizabeth E Krans, Scott D Rothenberger, Penelope K Morrison, Seo Young Park, Leah C Klocke, Mary J Turocy, Susan Zickmund
Objectives To evaluate Hepatitis C virus (HCV) knowledge and awareness among pregnant women with opioid use disorder (OUD). Methods From May through November 2015, a one-time survey was distributed to a convenience sample of pregnant women with OUD to assess their knowledge and awareness of (a) risk factors for HCV infection, (b) HCV transmission prevention strategies, (c) hepatotoxic risk reduction and (d) perinatal transmission and neonatal implications of HCV infection. Chi square and Fisher's exact tests were used to compare demographic characteristics and HCV knowledge between participants who were HCV positive and negative...
March 3, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29488294/agreement-between-paternal-self-reported-medication-use-and-records-from-a-national-prescription-database
#20
Jacqueline M Cohen, Mollie E Wood, Sonia Hernandez-Diaz, Hedvig Nordeng
PURPOSE: Father's medication use is of interest in fertility studies and as negative control exposures in pregnancy medication safety studies. We sought to compare self-report to prescription records to understand how reliably each of these sources of information may be used. METHODS: We compared self-reported medication use in the 6 months prior to pregnancy from fathers participating in the Norwegian Mother and Child Cohort Study to records of dispensed prescriptions from the Norwegian Prescription Database that overlapped in time...
February 28, 2018: Pharmacoepidemiology and Drug Safety
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