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Perinatal Drug Withdrawal

MedGen UID:
771100
•Concept ID:
C3642460
•
Mental or Behavioral Dysfunction

Definition

Withdrawal signs and symptoms that present during the perinatal period and are caused by drug use by the pregnant mother. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVPerinatal Drug Withdrawal

Professional guidelines

PubMed

A review of pregnancy-induced changes in opioid pharmacokinetics, placental transfer, and fetal exposure: Towards fetomaternal physiologically-based pharmacokinetic modeling to improve the treatment of neonatal opioid withdrawal syndrome.
van Hoogdalem MW, Wexelblatt SL, Akinbi HT, Vinks AA, Mizuno T
Pharmacol Ther 2022 Jun;234:108045. Epub 2021 Nov 20 doi: 10.1016/j.pharmthera.2021.108045. PMID: 34813863
Opioid Treatment for Neonatal Opioid Withdrawal Syndrome: Current Challenges and Future Approaches.
McPhail BT, Emoto C, Butler D, Fukuda T, Akinbi H, Vinks AA
J Clin Pharmacol 2021 Jul;61(7):857-870. Epub 2021 Feb 1 doi: 10.1002/jcph.1811. PMID: 33382111
Treatment of Perinatal Opioid Use Disorder.
Boyars L, Guille C
Obstet Gynecol Clin North Am 2018 Sep;45(3):511-524. doi: 10.1016/j.ogc.2018.05.001. PMID: 30092925

Recent clinical studies

Etiology

Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal.
Young LW, Ounpraseuth ST, Merhar SL, Hu Z, Simon AE, Bremer AA, Lee JY, Das A, Crawford MM, Greenberg RG, Smith PB, Poindexter BB, Higgins RD, Walsh MC, Rice W, Paul DA, Maxwell JR, Telang S, Fung CM, Wright T, Reynolds AM, Hahn DW, Ross J, McAllister JM, Crowley M, Shaikh SK, Puopolo KM, Christ L, Brown J, Riccio J, Wong Ramsey K, Akshatha, Braswell EF, Tucker L, McAlmon KR, Dummula K, Weiner J, White JR, Howell MP, Newman S, Snowden JN, Devlin LA; ACT NOW Collaborative
N Engl J Med 2023 Jun 22;388(25):2326-2337. Epub 2023 Apr 30 doi: 10.1056/NEJMoa2214470. PMID: 37125831Free PMC Article
Non-pharmacological care for opioid withdrawal in newborns.
Pahl A, Young L, Buus-Frank ME, Marcellus L, Soll R
Cochrane Database Syst Rev 2020 Dec 21;12(12):CD013217. doi: 10.1002/14651858.CD013217.pub2. PMID: 33348423Free PMC Article
Analgesia, Opioids, and Other Drug Use During Pregnancy and Neonatal Abstinence Syndrome.
Jones HE, Kraft WK
Clin Perinatol 2019 Jun;46(2):349-366. Epub 2019 Mar 30 doi: 10.1016/j.clp.2019.02.013. PMID: 31010564
Safety of Psychotropic Medications During Pregnancy.
Raffi ER, Nonacs R, Cohen LS
Clin Perinatol 2019 Jun;46(2):215-234. Epub 2019 Mar 28 doi: 10.1016/j.clp.2019.02.004. PMID: 31010557
Antidepressants, Antipsychotics, and Mood Stabilizers in Pregnancy: What Do We Know and How Should We Treat Pregnant Women with Depression.
Ornoy A, Weinstein-Fudim L, Ergaz Z
Birth Defects Res 2017 Jul 17;109(12):933-956. doi: 10.1002/bdr2.1079. PMID: 28714604

Diagnosis

Eat, Sleep, Console Approach or Usual Care for Neonatal Opioid Withdrawal.
Young LW, Ounpraseuth ST, Merhar SL, Hu Z, Simon AE, Bremer AA, Lee JY, Das A, Crawford MM, Greenberg RG, Smith PB, Poindexter BB, Higgins RD, Walsh MC, Rice W, Paul DA, Maxwell JR, Telang S, Fung CM, Wright T, Reynolds AM, Hahn DW, Ross J, McAllister JM, Crowley M, Shaikh SK, Puopolo KM, Christ L, Brown J, Riccio J, Wong Ramsey K, Akshatha, Braswell EF, Tucker L, McAlmon KR, Dummula K, Weiner J, White JR, Howell MP, Newman S, Snowden JN, Devlin LA; ACT NOW Collaborative
N Engl J Med 2023 Jun 22;388(25):2326-2337. Epub 2023 Apr 30 doi: 10.1056/NEJMoa2214470. PMID: 37125831Free PMC Article
Neonatal opioid withdrawal syndrome: a review of the science and a look toward the use of buprenorphine for affected infants.
Devlin LA, Young LW, Kraft WK, Wachman EM, Czynski A, Merhar SL, Winhusen T, Jones HE, Poindexter BB, Wakschlag LS, Salisbury AL, Matthews AG, Davis JM
J Perinatol 2022 Mar;42(3):300-306. Epub 2021 Sep 23 doi: 10.1038/s41372-021-01206-3. PMID: 34556799Free PMC Article
Safety of Psychotropic Medications During Pregnancy.
Raffi ER, Nonacs R, Cohen LS
Clin Perinatol 2019 Jun;46(2):215-234. Epub 2019 Mar 28 doi: 10.1016/j.clp.2019.02.004. PMID: 31010557
Long-term outcome of seizure-free patients and risk factors of relapse following antiepileptic drug withdrawal.
Ou S, Xia L, Li R, Wang L, Xia L, Zhou Q, Pan S
Epilepsy Behav 2018 Nov;88:295-300. Epub 2018 Oct 17 doi: 10.1016/j.yebeh.2018.09.028. PMID: 30340125
A Practical Approach to Neonatal Opiate Withdrawal Syndrome.
Devlin LA, Davis JM
Am J Perinatol 2018 Mar;35(4):324-330. Epub 2017 Nov 3 doi: 10.1055/s-0037-1608630. PMID: 29100261

Therapy

Non-pharmacological care for opioid withdrawal in newborns.
Pahl A, Young L, Buus-Frank ME, Marcellus L, Soll R
Cochrane Database Syst Rev 2020 Dec 21;12(12):CD013217. doi: 10.1002/14651858.CD013217.pub2. PMID: 33348423Free PMC Article
Opioid Use in Pregnancy.
Tobon AL, Habecker E, Forray A
Curr Psychiatry Rep 2019 Nov 16;21(12):118. doi: 10.1007/s11920-019-1110-4. PMID: 31734808Free PMC Article
Analgesia, Opioids, and Other Drug Use During Pregnancy and Neonatal Abstinence Syndrome.
Jones HE, Kraft WK
Clin Perinatol 2019 Jun;46(2):349-366. Epub 2019 Mar 30 doi: 10.1016/j.clp.2019.02.013. PMID: 31010564
Safety of Psychotropic Medications During Pregnancy.
Raffi ER, Nonacs R, Cohen LS
Clin Perinatol 2019 Jun;46(2):215-234. Epub 2019 Mar 28 doi: 10.1016/j.clp.2019.02.004. PMID: 31010557
Antidepressants, Antipsychotics, and Mood Stabilizers in Pregnancy: What Do We Know and How Should We Treat Pregnant Women with Depression.
Ornoy A, Weinstein-Fudim L, Ergaz Z
Birth Defects Res 2017 Jul 17;109(12):933-956. doi: 10.1002/bdr2.1079. PMID: 28714604

Prognosis

Zuranolone for the Treatment of Postpartum Depression.
Deligiannidis KM, Meltzer-Brody S, Maximos B, Peeper EQ, Freeman M, Lasser R, Bullock A, Kotecha M, Li S, Forrestal F, Rana N, Garcia M, Leclair B, Doherty J
Am J Psychiatry 2023 Sep 1;180(9):668-675. Epub 2023 Jul 26 doi: 10.1176/appi.ajp.20220785. PMID: 37491938
Opioid Treatment for Neonatal Opioid Withdrawal Syndrome: Current Challenges and Future Approaches.
McPhail BT, Emoto C, Butler D, Fukuda T, Akinbi H, Vinks AA
J Clin Pharmacol 2021 Jul;61(7):857-870. Epub 2021 Feb 1 doi: 10.1002/jcph.1811. PMID: 33382111
Long-term outcome of seizure-free patients and risk factors of relapse following antiepileptic drug withdrawal.
Ou S, Xia L, Li R, Wang L, Xia L, Zhou Q, Pan S
Epilepsy Behav 2018 Nov;88:295-300. Epub 2018 Oct 17 doi: 10.1016/j.yebeh.2018.09.028. PMID: 30340125
Hyperphagia, weight gain and neonatal drug withdrawal.
Shephard R, Greenough A, Johnson K, Gerada C
Acta Paediatr 2002;91(9):951-3. doi: 10.1080/080352502760272641. PMID: 12412871
Perinatal cocaine and methamphetamine exposure: maternal and neonatal correlates.
Oro AS, Dixon SD
J Pediatr 1987 Oct;111(4):571-8. doi: 10.1016/s0022-3476(87)80125-7. PMID: 3655989

Clinical prediction guides

Zuranolone for the Treatment of Postpartum Depression.
Deligiannidis KM, Meltzer-Brody S, Maximos B, Peeper EQ, Freeman M, Lasser R, Bullock A, Kotecha M, Li S, Forrestal F, Rana N, Garcia M, Leclair B, Doherty J
Am J Psychiatry 2023 Sep 1;180(9):668-675. Epub 2023 Jul 26 doi: 10.1176/appi.ajp.20220785. PMID: 37491938
The Negative Impact of Maternal Perinatal Opioid Use on Neonatal Outcomes.
Gandhi KD, Schak KM, Vande JL, Shekunov J, Lynch BA, Rummans TA, Geske JR, Pease ER, Limbeck MG, Desai J, Croarkin PE, Romanowicz M
Prim Care Companion CNS Disord 2021 Jun 10;23(3) doi: 10.4088/PCC.20m02737. PMID: 34115451Free PMC Article
Opioid Treatment for Neonatal Opioid Withdrawal Syndrome: Current Challenges and Future Approaches.
McPhail BT, Emoto C, Butler D, Fukuda T, Akinbi H, Vinks AA
J Clin Pharmacol 2021 Jul;61(7):857-870. Epub 2021 Feb 1 doi: 10.1002/jcph.1811. PMID: 33382111
Guidelines on treatment of perinatal depression with antidepressants: An international review.
Molenaar NM, Kamperman AM, Boyce P, Bergink V
Aust N Z J Psychiatry 2018 Apr;52(4):320-327. Epub 2018 Mar 5 doi: 10.1177/0004867418762057. PMID: 29506399Free PMC Article
Cocaine: maternal use during pregnancy and its effect on the mother, the fetus, and the infant.
Rosenak D, Diamant YZ, Yaffe H, Hornstein E
Obstet Gynecol Surv 1990 Jun;45(6):348-59. PMID: 2195406

Recent systematic reviews

Non-pharmacological care for opioid withdrawal in newborns.
Pahl A, Young L, Buus-Frank ME, Marcellus L, Soll R
Cochrane Database Syst Rev 2020 Dec 21;12(12):CD013217. doi: 10.1002/14651858.CD013217.pub2. PMID: 33348423Free PMC Article
Guidelines on treatment of perinatal depression with antidepressants: An international review.
Molenaar NM, Kamperman AM, Boyce P, Bergink V
Aust N Z J Psychiatry 2018 Apr;52(4):320-327. Epub 2018 Mar 5 doi: 10.1177/0004867418762057. PMID: 29506399Free PMC Article
Codeine, alone and with paracetamol (acetaminophen), for cancer pain.
Straube C, Derry S, Jackson KC, Wiffen PJ, Bell RF, Strassels S, Straube S
Cochrane Database Syst Rev 2014 Sep 19;2014(9):CD006601. doi: 10.1002/14651858.CD006601.pub4. PMID: 25234029Free PMC Article
Opiate treatment for opiate withdrawal in newborn infants.
Osborn DA, Cole MJ, Jeffery HE
Cochrane Database Syst Rev 2002;(3):CD002059. doi: 10.1002/14651858.CD002059. PMID: 12137642

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