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Opioid use and pregnancy

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https://www.readbyqxmd.com/read/29140822/optimizing-pregnancy-treatment-interventions-for-moms-opti-mom-a-pilot-study
#1
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
#2
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
#3
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/29049062/opioid-use-in-pregnancy
#4
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/28993061/risk-comparison-for-prenatal-use-of-analgesics-and-selected-birth-defects-national-birth-defects-prevention-study-1997-2011
#5
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
#6
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
#7
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/28917206/maternal-and-infant-outcomes-following-third-trimester-exposure-to-marijuana-in-opioid-dependent-pregnant-women-maintained-on-buprenorphine
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28877966/t-cell-mediation-of-pregnancy-analgesia-affecting-chronic-pain-in-mice
#11
Sarah F Rosen, Boram Ham, Shannon Drouin, Nadia Boachie, Anne-Julie Chabot-Dore, Jean-Sebastien Austin, Luda Diatchenko, Jeffrey S Mogil
It has been reported consistently that many female chronic pain sufferers have an attenuation of symptoms during pregnancy. Rats display increased pain tolerance during pregnancy due to an increase in opioid receptors in the spinal cord. Past studies did not consider the role of non-neuronal cells, which are now known to play an important role in chronic pain processing. Using an inflammatory (complete Freund's adjuvant) or neuropathic (spared nerve injury) model of persistent pain, we observed that young adult female mice in early pregnancy switch from a microglia-independent to a microglia-dependent pain hypersensitivity mechanism...
October 11, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28845959/sleep-disorders-restless-legs-syndrome
#12
REVIEW
Deepa Burman
Restless legs syndrome (RLS) is a common disorder that often is underdiagnosed and undertreated. Patients with RLS describe an urge to move their legs, especially in the evenings and during periods of inactivity. The prevalence of clinically significant RLS is approximately 2% to 3% in adults in Europe and North America. RLS can be an independent disorder or may occur in conjunction with other conditions (eg, iron deficiency, pregnancy, chronic renal failure). Diagnosis is based on clinical history. Routine polysomnography typically is not recommended unless there is suspicion of other sleep disorders (eg, obstructive sleep apnea)...
September 2017: FP Essentials
https://www.readbyqxmd.com/read/28840194/rectus-muscle-reapproximation-at-cesarean-delivery-and-postoperative-pain-a-randomized-controlled-trial
#13
Deirdre J Lyell, Mariam Naqvi, Amy Wong, Renata Urban, Brendan Carvalho
Objective  Rectus muscle reapproximation at cesarean delivery (CD) is performed frequently by some obstetricians; however, the effect on postoperative pain is unclear. To this end, we investigated whether rectus muscle reapproximation increases postoperative pain. Materials and Methods  This is a prospective, double-blind, randomized controlled trial of women undergoing primary CD with singleton or twin pregnancy at >35 weeks' gestation. Women were randomized to rectus muscle reapproximation with three interrupted sutures or no reapproximation...
July 2017: Surg J (N Y)
https://www.readbyqxmd.com/read/28829626/transitioning-from-methadone-to-buprenorphine-maintenance-in-management-of-opioid-use-disorder-during-pregnancy
#14
Shakevia Johnson, Peter R Martin
BACKGROUND: Opioid use disorder during pregnancy is a growing health concern. Methadone maintenance is the treatment of choice but emerging data indicate buprenorphine is a viable alternative. Due to costs and limited accessibility of methadone, pregnant women may require transition from methadone to buprenorphine for maintenance treatment. OBJECTIVES: To assess safety and effectiveness of transitioning from methadone to buprenorphine when necessary during pregnancy...
August 22, 2017: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/28807713/opioid-drug-use-and-acute-cardiac-events-among-pregnant-women-in-the-united-states
#15
Hamisu M Salihu, Jason L Salemi, Anjali Aggarwal, Beverly F Steele, Ross C Pepper, Mulubrhan F Mogos, Muktar H Aliyu
BACKGROUND: Cardiovascular disease remains a leading cause of pregnancy-associated deaths in the United States. The extent to which increasing opioid use among pregnant women contributes to fatal cardiovascular events is unknown. We examined trends in opioid use among pregnant women over the previous decade and the association between changes in temporal trends in opioid drug use and the incidence of acute cardiac events among mothers. METHODS: In this retrospective analysis of the Healthcare and Cost Utilization Project, we used a 2-stage stratified cluster sampling of all inpatient hospital discharges from nonfederal hospitals from January 1, 2002 through December 31, 2014...
August 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28806176/evaluating-the-use-of-ketamine-for-pain-control-with-sickle-cell-crisis-in-pregnancy-a-report-of-2-cases
#16
Alexis C Gimovsky, Kate Fritton, Eugene Viscusi, Amanda Roman
Sickle cell crises occur frequently during pregnancy and are difficult to treat, even with high-dose opioids. Analgesia with ketamine has been suggested as an alternative, but its use during pregnancy is underreported. Two pregnant patients with uncontrolled sickle cell pain were treated with ketamine. Patient A reported no decrease in her pain, but her opioid requirements decreased. Patient B's pain resolved during ketamine administration. No serious maternal or neonatal adverse effects occurred. Ketamine may be considered as an adjunct analgesic in pregnant patients with sickle cell pain, although prospective clinical data are needed to fully assess its efficacy...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28768628/risk-of-neonatal-drug-withdrawal-after-intrauterine-co-exposure-to-opioids-and-psychotropic-medications-cohort-study
#17
Krista F Huybrechts, Brian T Bateman, Rishi J Desai, Sonia Hernandez-Diaz, Kathryn Rough, Helen Mogun, Leslie S Kerzner, Jonathan M Davis, Megan Stover, Devan Bartels, Jennifer Cottral, Elisabetta Patorno
Objectives To assess the impact of in utero co-exposure to psychotropic medications and opioids on the incidence and severity of neonatal drug withdrawal.Design Observational cohort study.Setting Nationwide sample of pregnancies in publicly insured women in the US, nested in the Medicaid Analytic eXtract (2000-10).Participants 201 275 pregnant women with public insurance who were exposed to opioids around the time of delivery and their liveborn infants.Interventions In utero exposure to psychotropic medications, in particular antidepressants, atypical antipsychotics, benzodiazepines, gabapentin, and non-benzodiazepine hypnotics (Z drugs), with prescriptions filled within the same time window as prescriptions for opioids...
August 2, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28755770/association-of-methadone-dose-with-substance-use-and-treatment-retention-in-pregnant-and-postpartum-women-with-opioid-use-disorder
#18
Christine M Wilder, Daniel Hosta, Theresa Winhusen
BACKGROUND: In non-pregnant individuals being treated for opioid use disorder (OUD) with methadone, doses ≥60mg per day are associated with improved treatment retention and decreased illicit opioid use. Although methadone remains the first line treatment for OUD in pregnant women, there are no studies replicating this finding in pregnancy. METHODS: We conducted a retrospective cohort study of 189 pregnant women treated with methadone for OUD from 2006 to 2013...
September 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28754255/tailoring-a-nicu-based-tobacco-treatment-program-for-mothers-who-are-dependent-on-opioids
#19
Amanda Fallin-Bennett, Kristin Ashford
OBJECTIVE: To collect formative information to design a tailored tobacco treatment intervention for women with newborns treated or evaluated for neonatal abstinence syndrome and to explore current tobacco use behaviors and facilitators and barriers to smoking cessation. DESIGN: Qualitative descriptive study. SETTING: An academic medical center in the southern United States. PARTICIPANTS: Mothers (N = 11) of newborns who were treated or evaluated for neonatal abstinence syndrome at birth within the preceding 3 months...
September 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28742676/committee-opinion-no-711-opioid-use-and-opioid-use-disorder-in-pregnancy
#20
(no author information available yet)
Opioid use in pregnancy has escalated dramatically in recent years, paralleling the epidemic observed in the general population. To combat the opioid epidemic, all health care providers need to take an active role. Pregnancy provides an important opportunity to identify and treat women with substance use disorders. Substance use disorders affect women across all racial and ethnic groups and all socioeconomic groups, and affect women in rural, urban, and suburban populations. Therefore, it is essential that screening be universal...
August 2017: Obstetrics and Gynecology
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