From: hounddog23x@gmail.com   
      
   Pregnant Women Prescribed Opioids Have Babies More Likely To Suffer   
   Complications, Withdrawal Symptoms   
      
      
      
   Apr 14, 2015 11:54 AM   
   By   
   Susan Scutti   
      
      
   Medicaid-reimbursed doctors in Tennessee commonly prescribe opioid drugs to   
   pregnant women, a practice linked to newborn complications and infant   
   withdrawal symptoms.    
      
      
   Newborns whose pregnant mothers were prescribed opioid drugs may undergo   
   neonatal abstinence syndrome -- withdrawal symptoms, essentially. Infants   
   suffering withdrawal may experience breathing problems, convulsions, vomiting,   
   diarrhea, high-pitched    
   crying, poor appetite, jitteriness, tremors, sweating, fever, mottled skin,   
   and excessive sucking or rooting.   
      
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   A baby suffering in this way is horrifying to even imagine; however, it is   
   common for doctors reimbursed by the Tennessee Medicaid system to prescribe   
   opioid drugs to women who are pregnant, says a new study published in   
   Pediatrics, and this practice is    
   strongly linked to these symptoms as well as other newborn complications, such   
   as low birth weight.   
      
   "I always say neonatal abstinence syndrome looks like a colicy baby times   
   five," Dr. Stephen Patrick, assistant professor of pediatrics and health   
   policy, division of neonatology, Vanderbilt University, told Medical Daily.   
   The critical signs "first    
   present after a couple of days of life," Patrick said, adding "babies   
   typically stay in the hospital for three weeks."   
      
      
   For the study, Patrick and his colleagues used data from the medical records   
   of mothers and infants enrolled in the Tennessee Medicaid program between 2009   
   and 2011. Next, the team reviewed a random sample of medical records of babies   
   diagnosed with    
   neonatal abstinence syndrome in order to validate these diagnoses. Finally,   
   the team evaluated and analyzed cases of newborn withdrawal symptoms and   
   compared these to opioid prescription records.   
      
   "Of 112,029 pregnant women, 31,354 (28 percent) filled [one or more] opioid   
   prescriptions," wrote the authors in their study.   
      
   Infants with neonatal abstinence syndrome and infants whose mothers took   
   opioids while pregnant were more likely to have a low birth weight when   
   compared to infants who had never been exposed to these drugs. The numbers are   
   quite dramatic: 21.2 percent    
   of the babies suffering withdrawal had a lower than healthy birth weight   
   compared to just 9.9 percent of the unexposed babies.   
      
      
   "It's riskier to be born low-birth weight than to be born with neonatal   
   abstinence syndrome," Patrick told Medical Daily while also noting that low   
   birth weight comes with more potential long-term health risks. Though no   
   research into the long-term    
   effects of infant opioid withdrawal has been published, Patrick believes --   
   based on his knowledge of babies who suffered heroin withdrawal -- "there may   
   be no severe long term consequences" linked to opioid withdrawal, but these   
   children might have "   
   problems with attention."   
      
   The women who had been prescribed opioid pain relievers by their doctors were   
   more likely than those not prescribed opioids to smoke cigarettes (41.8   
   percent versus 25.8 percent). They also were more likely to be depressed or   
   have an anxiety disorder (   
   though these numbers were far smaller than the smoking numbers). That said,   
   pregnant mothers who either smoked or took a specific type of anti-depressant   
   while using opioids were more likely to give birth to babies suffering   
   withdrawal symptoms.   
      
   National Trends   
      
   Opioids relieve pain and include hydrocodone (Vicodin, for example), oxycodone   
   (OxyContin and Percocet are examples), morphine (including Kadian and Avinza),   
   codeine, and related drugs. Hydrocodone products are the most commonly   
   prescribed opioids for    
   certain everyday conditions, including dental and injury-related pain.   
   Morphine is more often used before and after surgical procedures to alleviate   
   severe pain, while codeine is often prescribed for mild pain. Sometimes   
   doctors prescribe codeine and    
   diphenoxylate (Lomotil) to relieve coughs and severe diarrhea as well.   
      
      
   The 2010 National Survey on Drug Use and Health found an estimated 2.4 million   
   Americans used prescription drugs non-medically for the first time within the   
   past year, which the National Institute on Drug Abuse calculates as 6,600   
   initiates per day. More    
   than one-half were women.     
      
   While most people commonly believe misuse of opioids among people with chronic   
   pain is an increasing problem, scientific studies show a wide range of   
   opinions on the matter, with some reporting "problem use" rates as less than   
   one percent and others    
   reporting as high as 81 percent. Most studies, though, reported misuse as   
   ranging between 21 percent and 29 percent. American patients who suffer from   
   chronic pain number roughly 116 million.   
      
   "In global terms, the United States makes up 4.6 percent of the world's   
   population yet 80 percent of the total consumption of opioid pain relievers,"   
   Patrick told Medical Daily. "Overdose deaths attributed to opioid prescription   
   drugs account for more    
   deaths than car accidents." His study highlights the need for a public policy   
   concerning how these drugs are prescribed in order to limit the detrimental   
   impact on everyone... but "especially Mom's and babies," said Patrick.   
      
   Source: Patrick SW, Dudley J, Martin PR, et al. Prescription Opioid Epidemic   
   and Infant Outcomes. Pediatrics. 2015.   
      
   Note: An earlier version of this article did not include remarks from Dr.   
   Stephen Patrick.   
      
   http://www.medicaldaily.com/pregnant-women-prescribed-opioids-ha   
   e-babies-more-likely-suffer-complications-329128   
      
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