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opioids and pregnancy

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https://www.readbyqxmd.com/read/29226017/buprenorphine-for-medication-assisted-treatment-of-opioid-use-disorder-in-pregnancy-relationship-to-neonatal-opioid-withdrawal-syndrome
#1
Niraj R Chavan, Kristin B Ashford, Amanda T Wiggins, Michelle R Lofwall, Agatha S Critchfield
Objective  To examine the relationship between antepartum buprenorphine dose for medication-assisted treatment (MAT) of opioid use disorder (OUD) and incident neonatal opioid withdrawal syndrome (NOWS). Study Design  We performed a prospective cohort study of pregnant women with a singleton gestation diagnosed with OUD and receiving buprenorphine for MAT at a tertiary care academic institution from July 2015 to January 2017. We divided the study cohort into two groups-pregnancies with versus without NOWS...
October 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29223211/perinatal-and-neonatal-implications-of-sickle-cell-disease
#2
Cathi Phillips, Margaret Peggy Boyd
Sickle cell disease is the genetic disorder most commonly detected with state-mandated newborn screening. Women with sickle cell disease struggle with psychosocial, emotional, and physical challenges throughout their lives. Pregnancy for women with sickle cell disease brings greater risk for maternal and fetal morbidity and mortality and increased likelihood of hospitalization for complications, including sickle cell pain crisis. Chronic maternal opioid use for pain can place newborns at risk for neonatal abstinence syndrome...
December 2017: Nursing for Women's Health
https://www.readbyqxmd.com/read/29200828/fentanyl-induced-respiratory-depression-is-attenuated-in-pregnant-patients
#3
Xiaofei Cao, Shijiang Liu, Jie Sun, Min Yu, Yin Fang, Zhengnian Ding
Background: Respiratory depression is a complication of intravenous fentanyl administration. The effect of pregnancy on respiratory depression following opioid administration is unclear. This study investigated the effect of pregnancy on fentanyl-induced respiratory depression. Patients and methods: Female patients were divided into three groups (n=20 per group): control group (non-pregnant and scheduled for laparoscopic surgery), early pregnancy group (pregnant for 45-60 days and scheduled for abortion), and postpartum group (5-7 days postpartum scheduled for complete curettage of uterine cavity)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29183818/federal-and-state-policy-efforts-to-address-maternal-opioid-misuse-gaps-and-challenges
#4
Jennifer B Saunders, Marian P Jarlenski, Robert Levy, Katy B Kozhimannil
BACKGROUND: Opioid misuse during pregnancy is increasingly common and is associated with preterm birth and neonatal abstinence syndrome. As such, there is increased policy attention on reducing opioid misuse and increasing detection and treatment of opioid use disorder around the time of childbirth. METHODS: We conducted a review of peer-reviewed and grey literature to identify policy strategies to address opioid misuse among pregnant women; to describe current federal and state laws that impact women before pregnancy, during pregnancy, at birth, and postpartum; and to identify gaps and challenges related to these efforts...
November 25, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29162530/a-retrospective-chart-review-of-contraceptive-use-among-adolescents-with-opioid-use-disorder
#5
Caitlin J Handy, Hannah L H Lange, Brittny E Manos, Elise D Berlan, Andrea E Bonny
STUDY OBJECTIVES: To describe contraceptive use among female adolescents initiating outpatient treatment for opioid use disorder. DESIGN: Retrospective chart review. SETTING: Outpatient clinic providing medication-assisted treatment for substance use disorders to adolescents and young adults. PARTICIPANTS: Non-pregnant female adolescents presenting for treatment from January 1, 2013 to January 31, 2016 (N=123). INTERVENTION: None...
November 18, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/29155916/a-novel-strategy-to-address-unmeasured-confounding-when-comparing-opioid-agonist-therapies-in-pregnancy
#6
Lara S Lemon
Opioid addiction in pregnancy is a growing concern that has recently received a lot of attention. When comparing recommended opioid agonist therapies, many currently published studies guiding practice may be impacted by unmeasured confounding by indication. Populations of women who receive methadone are generally different from those treated with buprenorphine. Women treated with methadone frequently have more severe and uncontrolled addiction compared with buprenorphine treated patients; however, these factors are typically unmeasured or unavailable in large observational data sets...
November 16, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/29140822/optimizing-pregnancy-treatment-interventions-for-moms-opti-mom-a-pilot-study
#7
Gerald T Cochran, Valerie Hruschak, Walitta Abdullah, Elizabeth Krans, Antoine B Douaihy, Stephanie Bobby, Rachel Fusco, Ralph Tarter
OBJECTIVES: The public health burden of opioid use disorder (OUD) among pregnant women has significantly increased in recent years. The Optimizing Pregnancy Treatment Interventions for Moms study was a pilot project that examined the feasibility of a patient navigation (PN) intervention model to reduce substance use and improve mental health, quality of life, and to increase engagement with treatment services among pregnant women with OUD. METHODS: A 1-group repeated-measures pilot study was conducted with treatment-seeking pregnant women with opioid dependence initiating buprenorphine maintenance treatment...
November 14, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29130600/opioid-dependence-and-pregnancy-in-early-twentieth-century-america
#8
Nathan Tauger
BACKGROUND AND AIMS: Research on Neonatal Abstinence Syndrome has prompted discussion over how to ensure best outcomes for pregnant women who use drugs and for drug-dependent newborns. Before Neonatal Abstinence Syndrome and the 1980s panic of "crack babies," turn-of-the-century American medical journals discussed infants born to drug-using mothers. This paper aimed to determine whether women who used drugs while pregnant in early twentieth-century America were subject to the stigma many face today...
November 11, 2017: Addiction
https://www.readbyqxmd.com/read/29073311/expanding-treatment-opportunities-for-hospitalized-patients-with-opioid-use-disorders
#9
Daniel Winetsky, Robert M Weinrieb, Jeanmarie Perrone
The prevalence of opioid use disorders (OUDs) is rising across the United States. Patients with OUDs are often hospitalized for medical conditions other than addiction, such as infection, injury, or pregnancy. These hospital admissions provide an opportunity for healthcare providers to initiate opioid agonist therapy with methadone or buprenorphine. Randomized trials have demonstrated the superior effectiveness of this treatment strategy, but its adoption by hospital providers has been slow. A number of barriers have impeded its implementation, including misperceptions about the regulation of opioid prescribing, limited resources for the transition to community- based treatment, and a lack of familiarity among clinicians about the appropriate initiation and dose adjustment of these opioid agonists for maintenance therapy...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29068826/opioid-addiction-in-pregnancy-does-depression-negatively-impact-adherence-with-prenatal-care
#10
Lauren Hensley, Suela Sulo, Sarah Kozmic, Barbara V Parilla
OBJECTIVE: We aimed to evaluate whether depression in pregnancy in women with opioid dependency negatively impacts adherence with prenatal care. METHODS: This was a retrospective chart analysis of opioid-dependent pregnant women over a 6-year period at 2 large referral and tertiary care centers. The primary outcome was adherence with prenatal care based on the concurrent diagnosis of depression. Adherence was assessed by looking at the number of observed versus expected prenatal visits...
October 24, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29049062/opioid-use-in-pregnancy
#11
Molly M Killion
No abstract text is available yet for this article.
November 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/29039297/the-impact-of-periconceptional-alcohol-exposure-on-fat-preference-and-gene-expression-in-the-mesolimbic-reward-pathway-in-adult-rat-offspring
#12
E S Dorey, C L Cullen, D Lucia, K M Mah, M-L Roy Manchadi, B S Muhlhausler, K M Moritz
Alcohol consumption around the time of conception is highly prevalent in Western countries. Exposure to ethanol levels during gestation has been associated with altered development of the mesolimbic reward pathway in rats and increased propensity to addiction, however the effect of exposure only around the time of conception is unknown. The current study investigated the effects of periconceptional alcohol exposure (PC:EtOH) on alcohol and palatable food preferences and gene expression in the ventral tegmental area (VTA) and the nucleus accumbens of the adult offspring...
October 17, 2017: Journal of Developmental Origins of Health and Disease
https://www.readbyqxmd.com/read/28994902/corrected-qt-interval-and-methadone-dose-and-concentrations-in-pregnant-and-postpartum-women
#13
Debra L Bogen, Barbara H Hanusa, James M Perel, Frederick Sherman, Marla A Mendelson, Katherine L Wisner
BACKGROUND: Methadone is a standard treatment for opioid dependence in pregnancy; however, its impact on maternal corrected QT interval (QTc) has not been evaluated. We studied the association between methadone dose and enantiomer-specific plasma concentrations and QTc among pregnant and postpartum women and newborns. We assessed the relevance of QTc screening guidelines for pregnant women and infants. METHODS: From 2006 to 2008, plasma methadone concentrations were measured during pregnancy, postpartum, and in cord blood in women treated for opioid dependence at a single treatment program...
September 26, 2017: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28993061/risk-comparison-for-prenatal-use-of-analgesics-and-selected-birth-defects-national-birth-defects-prevention-study-1997-2011
#14
Julia D Interrante, Elizabeth C Ailes, Jennifer N Lind, Marlene Anderka, Marcia L Feldkamp, Martha M Werler, Lockwood G Taylor, James Trinidad, Suzanne M Gilboa, Cheryl S Broussard
PURPOSE: To compare the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and/or opioids to the use of acetaminophen without NSAIDs or opioids with respect to associations with birth defects. METHODS: We used data from the National Birth Defects Prevention Study (1997-2011). Exposure was self-reported maternal analgesic use from the month before through the third month of pregnancy (periconceptional). Adjusted odds ratios (aORs) were calculated to examine associations with 16 birth defects...
October 2017: Annals of Epidemiology
https://www.readbyqxmd.com/read/28962601/a-systematic-overview-of-the-literature-regarding-group-prenatal-care-for-high-risk-pregnant-women
#15
Brittany M Byerley, David M Haas
BACKGROUND: Group prenatal care (GPC) models have been gaining popularity in recent years. Studies of high-risk groups have shown improved outcomes. Our objective was to review and summarize outcomes for women in GPC for women with specific high-risk conditions. METHODS: A systematic literature review of Ovid, PubMed, and Google Scholar was performed to identify studies reporting the effects of group prenatal care in high-risk populations. Studies were included if they reported on pregnancy outcome results for women using GPC...
September 29, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28950109/care-experiences-of-women-who-used-opioids-and-experienced-fetal-or-infant-loss
#16
Lisa F Scott, Carol Shieh, Rachel A Umoren, Teri Conard
OBJECTIVE: To explore care experiences of women who used prescription or illicit opioids and experienced fetal or infant loss. DESIGN: A qualitative, descriptive design with secondary data analysis. SETTING: The Fetal and Infant Mortality Review program in an urban Midwestern county in the United States. PARTICIPANTS: Eleven women with histories of prescription or illicit opioid use who experienced fetal or infant loss participated in the semistructured telephone or in-person interview portion of the mortality case review...
November 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28922338/does-the-%C3%AE-receptor-antagonist-esmolol-have-analgesic-effects-a-randomised-placebo-controlled-cross-over-study-on-healthy-volunteers-undergoing-the-cold-pressor-test
#17
Fredrik Ander, Anders Magnuson, Alex de Leon, Rebecca Ahlstrand
BACKGROUND: Esmolol may attenuate the sympathetic response to pain and reduce postoperative opioid consumption. It is not clear whether esmolol has an analgesic effect per se. OBJECTIVES: The aim of this study was to evaluate the analgesic effect of esmolol in the absence of anaesthetics and opioids. We tested the hypothesis that esmolol would reduce the maximum pain intensity perceived during the cold pressor test (CPT) by 2 points on a 0 to 10 numeric pain rating scale (NRS) compared to placebo...
September 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28917206/maternal-and-infant-outcomes-following-third-trimester-exposure-to-marijuana-in-opioid-dependent-pregnant-women-maintained-on-buprenorphine
#18
Alane B O'Connor, Brandon K Kelly, Liam M O'Brien
BACKGROUND: To determine whether maternal and infant outcomes are associated with exposure to marijuana during the third trimester in a population of opioid dependent pregnant women maintained on buprenorphine. METHODS: This retrospective cohort study of 191 maternal-infant dyads exposed to buprenorphine during pregnancy examines a variety of variables including gestational age, birthweight, method of delivery, Apgar scores at one and five minutes, duration of infant hospital stay, peak neonatal abstinence syndrome (NAS) score, duration of NAS and incidence of pharmacologic treatment of NAS in infants exposed to marijuana during the third trimester as compared to infants not exposed to marijuana during the third trimester...
November 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28898707/the-effect-of-prenatal-substance-use-and-maternal-contingent-responsiveness-on-infant-affect
#19
Jean Lowe, Fares Qeadan, Lawrence Leeman, Shikhar Shrestha, Julia M Stephen, Ludmila N Bakhireva
BACKGROUND: The effects of prenatal substance exposure on neurobehavioral outcomes are inherently confounded by the effects of the postnatal environment, making it difficult to disentangle their influence. The goal of this study was to examine the contributing effects of prenatal substance use and parenting style (operationalized as contingent responding during the play episodes of the Still-face paradigm [SFP]) on infant affect. METHODS: A prospective cohort design was utilized with repeated assessment of substance use during pregnancy and the administration of the SFP, which measures infant response to a social stressor, at approximately 6months of age...
December 2017: Early Human Development
https://www.readbyqxmd.com/read/28888583/food-and-drug-administration-warning-on-anesthesia-and-brain-development-implications-for-obstetric-and-fetal-surgery
#20
Olutoyin A Olutoye, Byron Wycke Baker, Michael A Belfort, Oluyinka O Olutoye
There has been growing concern about the detrimental effects of certain anesthetic agents on the developing brain. Preclinical studies in small animal models as well as nonhuman primates suggested loss or death of brain cells and consequent impaired neurocognitive function following anesthetic exposure in neonates and late gestation fetuses. Human studies in this area are limited and currently inconclusive. On Dec. 14, 2016, the US Food and Drug Administration issued a warning regarding impaired brain development in children following exposure to certain anesthetic agents used for general anesthesia, namely the inhalational anesthetics isoflurane, sevoflurane, and desflurane, and the intravenous agents propofol and midazolam, in the third trimester of pregnancy...
September 6, 2017: American Journal of Obstetrics and Gynecology
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