Narcotic tapering in pregnancy using long-acting morphine: an 18-month prospective cohort study in northwestern Ontario

To document the management of and outcomes for patients receiving narcotic replacement and tapering with long-acting morphine preparations during pregnancy. A prospective cohort study over 18 months. Northwestern Ontario. All 600 births at Meno Ya Win Health Centre in Sioux Lookout, Ont, from Januar...

Full description

Saved in:
Bibliographic Details
Published in:Canadian family physician 2015-02, Vol.61 (2), p.e88-e95
Main Authors: Dooley, Roisin, Dooley, Joe, Antone, Irwin, Guilfoyle, John, Gerber-Finn, Lianne, Kakekagumick, Kara, Cromarty, Helen, Hopman, Wilma, Muileboom, Jill, Brunton, Nicole, Kelly, Len
Format: Article
Language:English
Subjects:
Adult
Delayed-Action Preparations - administration & dosage
Drug use
Female
Humans
Incidence
Infant, Newborn
Male
Maternal-Fetal Exchange - drug effects
Morphine - administration & dosage
Morphine - toxicity
Narcotics
Narcotics - administration & dosage
Narcotics - toxicity
Neonatal Abstinence Syndrome - epidemiology
Neonatal Abstinence Syndrome - etiology
Ontario - epidemiology
Opioid-Related Disorders - ethnology
Pregnancy
Pregnancy Complications - chemically induced
Pregnancy Complications - epidemiology
Prospective Studies
Young Adult
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To document the management of and outcomes for patients receiving narcotic replacement and tapering with long-acting morphine preparations during pregnancy. A prospective cohort study over 18 months. Northwestern Ontario. All 600 births at Meno Ya Win Health Centre in Sioux Lookout, Ont, from January 1, 2012, to June 30, 2013, including 166 narcotic-exposed pregnancies. Narcotic replacement and tapering of narcotic use with long-acting morphine preparations. Prenatal management of maternal narcotic use, incidence of neonatal abstinence syndrome, and other neonatal outcomes. The incidence of neonatal abstinence syndrome fell significantly to 18.1% of pregnancies exposed to narcotics (from 29.5% in a previous 2010 study, P = .003) among patients using narcotic replacement and tapering with long-acting morphine preparations. Neonatal outcomes were otherwise equivalent to those of the nonexposed pregnancies. In many patients, long-acting morphine preparations can be safely used and tapered in pregnancy, with a subsequent decrease in observed neonatal withdrawal symptoms.
ISSN:0008-350X
1715-5258