The obstetrical and neonatal impact of maternal opioid detoxification in pregnancy

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Abstract

Objective: The purpose of this study was to analyze the obstetric and neonatal impact of an opioid detoxification program during pregnancy, as well as to examine variables associated with successful opioid detoxification. Study Design: This is a retrospective cohort study of women electing inpatient detoxification and subsequently delivering at our hospital from Jan. 1, 2006, through Dec. 31, 2011. Detoxification was considered successful if women had no illicit drug supplementation at the time of delivery. Maternal characteristics were ascertained by chart review and analyzed for variables associated with success. Obstetric and neonatal outcomes were also assessed based on maternal success at delivery. Results: Of the 95 women during the study period with complete data, 53 (56%) were successful. There were no demographic or social risk factors identified associated with success. Women with successful detoxification at delivery had longer inpatient detoxification admissions (median 25 vs 15 days, P <.001) and were less likely to leave prior to completion of the program than women who had relapsed at delivery (9% vs 33%, respectively, P <.001). Infants of mothers who were successfully detoxified had shorter hospitalizations (median 3 vs 22 days, P <.001), lower maximum neonatal abstinence syndrome scores (0 vs 8.3, P <.001), and were less likely to be treated for withdrawal (10% vs 80%, P <.001). Conclusion: Opiate detoxification in pregnancy requires a significant time commitment and extended treatment, however, can be successfully achieved in compliant parturients. Importantly, maternal demographics and drug histories do not portend success, supporting continued opiate detoxification being offered to all women expressing intent.

Original languageEnglish (US)
JournalAmerican Journal of Obstetrics and Gynecology
Volume209
Issue number3
DOIs
StatePublished - Sep 2013

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Opioid Analgesics
Mothers
Pregnancy
Opiate Alkaloids
Obstetrics
Inpatients
Neonatal Abstinence Syndrome
Demography
Street Drugs
Hospitalization
Cohort Studies
Retrospective Studies
Parturition
Pharmaceutical Preparations

Keywords

  • drug use in pregnancy
  • methadone detoxification
  • opioid detoxification

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

@article{a0b97f10e9e742b98529e1abc1e63f29,
title = "The obstetrical and neonatal impact of maternal opioid detoxification in pregnancy",
abstract = "Objective: The purpose of this study was to analyze the obstetric and neonatal impact of an opioid detoxification program during pregnancy, as well as to examine variables associated with successful opioid detoxification. Study Design: This is a retrospective cohort study of women electing inpatient detoxification and subsequently delivering at our hospital from Jan. 1, 2006, through Dec. 31, 2011. Detoxification was considered successful if women had no illicit drug supplementation at the time of delivery. Maternal characteristics were ascertained by chart review and analyzed for variables associated with success. Obstetric and neonatal outcomes were also assessed based on maternal success at delivery. Results: Of the 95 women during the study period with complete data, 53 (56{\%}) were successful. There were no demographic or social risk factors identified associated with success. Women with successful detoxification at delivery had longer inpatient detoxification admissions (median 25 vs 15 days, P <.001) and were less likely to leave prior to completion of the program than women who had relapsed at delivery (9{\%} vs 33{\%}, respectively, P <.001). Infants of mothers who were successfully detoxified had shorter hospitalizations (median 3 vs 22 days, P <.001), lower maximum neonatal abstinence syndrome scores (0 vs 8.3, P <.001), and were less likely to be treated for withdrawal (10{\%} vs 80{\%}, P <.001). Conclusion: Opiate detoxification in pregnancy requires a significant time commitment and extended treatment, however, can be successfully achieved in compliant parturients. Importantly, maternal demographics and drug histories do not portend success, supporting continued opiate detoxification being offered to all women expressing intent.",
keywords = "drug use in pregnancy, methadone detoxification, opioid detoxification",
author = "Stewart, {Robert D.} and Nelson, {David B.} and Adhikari, {Emily H.} and McIntire, {Donald D.} and Roberts, {Scott W.} and Dashe, {Jodi S.} and Sheffield, {Jeanne S.}",
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AU - Stewart, Robert D.

AU - Nelson, David B.

AU - Adhikari, Emily H.

AU - McIntire, Donald D.

AU - Roberts, Scott W.

AU - Dashe, Jodi S.

AU - Sheffield, Jeanne S.

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N2 - Objective: The purpose of this study was to analyze the obstetric and neonatal impact of an opioid detoxification program during pregnancy, as well as to examine variables associated with successful opioid detoxification. Study Design: This is a retrospective cohort study of women electing inpatient detoxification and subsequently delivering at our hospital from Jan. 1, 2006, through Dec. 31, 2011. Detoxification was considered successful if women had no illicit drug supplementation at the time of delivery. Maternal characteristics were ascertained by chart review and analyzed for variables associated with success. Obstetric and neonatal outcomes were also assessed based on maternal success at delivery. Results: Of the 95 women during the study period with complete data, 53 (56%) were successful. There were no demographic or social risk factors identified associated with success. Women with successful detoxification at delivery had longer inpatient detoxification admissions (median 25 vs 15 days, P <.001) and were less likely to leave prior to completion of the program than women who had relapsed at delivery (9% vs 33%, respectively, P <.001). Infants of mothers who were successfully detoxified had shorter hospitalizations (median 3 vs 22 days, P <.001), lower maximum neonatal abstinence syndrome scores (0 vs 8.3, P <.001), and were less likely to be treated for withdrawal (10% vs 80%, P <.001). Conclusion: Opiate detoxification in pregnancy requires a significant time commitment and extended treatment, however, can be successfully achieved in compliant parturients. Importantly, maternal demographics and drug histories do not portend success, supporting continued opiate detoxification being offered to all women expressing intent.

AB - Objective: The purpose of this study was to analyze the obstetric and neonatal impact of an opioid detoxification program during pregnancy, as well as to examine variables associated with successful opioid detoxification. Study Design: This is a retrospective cohort study of women electing inpatient detoxification and subsequently delivering at our hospital from Jan. 1, 2006, through Dec. 31, 2011. Detoxification was considered successful if women had no illicit drug supplementation at the time of delivery. Maternal characteristics were ascertained by chart review and analyzed for variables associated with success. Obstetric and neonatal outcomes were also assessed based on maternal success at delivery. Results: Of the 95 women during the study period with complete data, 53 (56%) were successful. There were no demographic or social risk factors identified associated with success. Women with successful detoxification at delivery had longer inpatient detoxification admissions (median 25 vs 15 days, P <.001) and were less likely to leave prior to completion of the program than women who had relapsed at delivery (9% vs 33%, respectively, P <.001). Infants of mothers who were successfully detoxified had shorter hospitalizations (median 3 vs 22 days, P <.001), lower maximum neonatal abstinence syndrome scores (0 vs 8.3, P <.001), and were less likely to be treated for withdrawal (10% vs 80%, P <.001). Conclusion: Opiate detoxification in pregnancy requires a significant time commitment and extended treatment, however, can be successfully achieved in compliant parturients. Importantly, maternal demographics and drug histories do not portend success, supporting continued opiate detoxification being offered to all women expressing intent.

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