Opioid Use in Pregnancy

Purpose of Review Perinatal opioid use is a major public health problem and is associated with a number of deleterious maternal and fetal effects. We review recent evidence of perinatal outcomes and treatment of opioid use disorder (OUD) during pregnancy. Recent Findings Opioid exposure in pregnancy...

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Bibliographic Details
Published in:	Current psychiatry reports 2019-12, Vol.21 (12), p.118-118, Article 118
Main Authors:	Tobon, Amalia Londono, Habecker, Erin, Forray, Ariadna
Format:	Article
Language:	eng
Subjects:	Buprenorphine - therapeutic use Child Development - drug effects Female Humans Infant, Newborn Medicine Medicine & Public Health Methadone - therapeutic use Neonatal Abstinence Syndrome - prevention & control Opiate Substitution Treatment Opioid-Related Disorders - drug therapy Pregnancy Pregnancy Complications - drug therapy Psychiatry Reproductive Psychiatry and Women's Health (CN Epperson and L Hantsoo Section Editors Topical Collection on Reproductive Psychiatry and Women's Health Treatment Outcome
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Summary:	Purpose of Review Perinatal opioid use is a major public health problem and is associated with a number of deleterious maternal and fetal effects. We review recent evidence of perinatal outcomes and treatment of opioid use disorder (OUD) during pregnancy. Recent Findings Opioid exposure in pregnancy is associated with multiple obstetric and neonatal adverse outcomes, with the most common being neonatal opioid withdrawal syndrome (NOWS). Treatment with buprenorphine or methadone is associated with NOWS, but neither medication appears to have significant adverse effects on early childhood development. Buprenorphine appears to be superior to methadone in terms of incidence and severity of NOWS in exposed infants. The long-term effects of opioid exposure in utero have been inconclusive, but recent longitudinal studies point to potential differences in brain morphology that may increase vulnerability to future stressors. Summary Maintenance therapy with methadone or buprenorphine remains the standard of care for pregnant women with OUD given its consistent superiority to placebo in terms of rates of illicit drug use and pregnancy outcomes. New non-pharmacologic management options for NOWS appear promising. Future research is needed to further evaluate the effects of opioid exposure in utero and determine the optimal delivery model for maintenance therapy.
ISSN:	1523-3812 1535-1645