Babies exposed to narcotic pain relievers more likely to experience withdrawal

Neonatal abstinence syndrome (NAS), a drug withdrawal syndrome in infants following birth, has historically been associated with illicit drug use among pregnant women.

But a study by a team at Vanderbilt University Medical Center shows that pregnant women are commonly being prescribed opioids - narcotic pain relievers such as hydrocodone - which results in an increased likelihood of NAS. In addition, the study found that opioid type and duration of exposure combined with tobacco use or selective serotonin reuptake inhibitor use (for treating depression and anxiety) augmented risks for NAS.

The study, "Prescription Opioid Epidemic and Infant Outcomes," looked at three years of data from TennCare, Tennessee's Medicaid program, and assessed records for 112,029 pregnant mothers. An estimated 28 percent of the women, or 31,354, were prescribed and filled at least one opioid pain reliever. Of the babies with NAS, 65 percent had mothers that legally filled prescriptions for opioid pain relievers. Results were published today/April 13 in the journal Pediatrics.

"We found that babies exposed to opioids pain relievers were more likely to be born preterm, have complicated births, low birth weight and have complications such as meconium aspiration syndrome (a sign of infant distress at birth) and respiratory distress," said lead author Stephen Patrick, M.D., MPH, assistant professor of Pediatrics and Health Policy in the Division of Neonatology with the Monroe Carell Jr. Children's Hospital at Vanderbilt.

Neonatal abstinence syndrome (NAS), a drug withdrawal syndrome in infants following birth, has historically been associated with illicit drug use among pregnant women.

But a study by a team at Vanderbilt University Medical Center shows that pregnant women are commonly being prescribed opioids - narcotic pain relievers such as hydrocodone - which results in an increased likelihood of NAS. In addition, the study found that opioid type and duration of exposure combined with tobacco use or selective serotonin reuptake inhibitor use (for treating depression and anxiety) augmented risks for NAS.

A newborn infant born to a mother dependent on opioids or other substances is at risk for drug withdrawal commonly referred to as neonatal abstinence syndrome (NAS). NAS is a variable, complex, and incompletely understood spectrum of signs of neonatal behavioral dysregulation. It is not defined by the need for pharmacotherapy. Although most commonly associated with opioid exposure, other substances have been associated with NAS, including sedative-hypnotics.

Most common opioids in neonatal abstinence syndrome (NAS) - In the United States, heroin and methadone are the most common opioids to which infants are exposed prenatally. However, in the United States, the incidence of in utero exposures to licit opioids (eg, hydrocodone) and buprenorphine is increasing.