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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.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Stewart RD,Nelson DB,Adhikari EH,McIntire DD,Roberts SW,Dashe JS,Sheffield JS

doi

10.1016/j.ajog.2013.05.026

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

267.e1-5

issue

3

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(13)00513-9

journal_volume

209

pub_type

杂志文章

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