Neonatal opioid withdrawal syndrome (NOWS) affects infants exposed to opioids in utero. With the increase in both unprescribed and prescribed opioids use in the U.S., there has been a five-fold increase in the rate of NOWS over the past decade. Approximately 50 to 80 percent of opioid-exposed infants have required medication to manage their withdrawal symptoms, which usually appear two to three days after birth. These can include irritability, trouble eating and sleeping, diarrhea, muscle rigidity, and difficulty soothing.
Naltrexone, buprenorphine and methadone are three FDA-approved medications prescribed to treat opioid use disorder. However, there is limited data on the use of naltrexone during pregnancy in terms of safety and efficacy given its relative short time on the market. This study, published in Clinical Therapeutics, followed mother-infant dyads during their pregnancy and after delivery at one academic medical center between 2017 and 2019. Six of the mothers were taking naltrexone to treat their opioid use disorder before and during their pregnancy, and 12 were taking buprenorphine. The two groups were monitored and compared based on participants' opioid use via urine toxicology reports, provider reports during pregnancy and six months post-delivery, delivery outcomes, gestational age, birth weight, APGAR scores, NICU admission, and NOWS outcomes (diagnosis, pharmacologic treatment, total hospital length of stay). Maternal demographics were also compared between all participants.
Infants - Women - Naltrexone - Withdrawal - Symptoms
The infants born to women taking naltrexone showed no withdrawal symptoms during their initial hospitalization, compared to 92 percent of infants born to women taking buprenorphine. Of those showing symptoms, 46 percent required medication to treat their withdrawal symptoms. Additionally, 83 percent of women in the naltrexone cohort breastfed, without any immediate issues in the perinatal period.
"While these study...
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