Management and monitoring of opioid use in pregnancy

Nete Lundager Klokker Rausgaard*, Inge Olga Ibsen, Jan Stener Jørgensen, Ronald Francis Lamont, Pernille Ravn

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Resumé

Opioid use during pregnancy has serious consequences for mother and baby. The true extent of the problem is unknown and there is a need for better screening. Existing guidelines with respect to the management of pregnant women with opioid use are based on limited evidence. To improve recommendations for optimal identification, management, and treatment, publications on opioids in pregnancy were reviewed. Published literature from 2007 to 2017 was searched in PubMed, Cochrane and Embase databases. The review employed 60 publications from 210 studies identified, that were of varying quality and included randomized controlled trials, systematic reviews, meta-analyses, and Cochrane reviews. The prevalence of opioid use in pregnancy is underestimated. Screening by urine testing and self-reporting is acceptable to identify fetal exposure. To minimize risk, opioid agonist pharmacotherapy should replace the continued use of opioids or detoxification. Current guidelines recommend methadone and buprenorphine equally. However, recent studies indicate that buprenorphine has advantages over methadone. Accordingly, we suggest buprenorphine as first-line therapy. Future studies should elaborate on better objective screening methods to prevent the consequences of fetomaternal opioid exposure.

OriginalsprogEngelsk
TidsskriftActa Obstetricia et Gynecologica Scandinavica
Vol/bind99
Udgave nummer1
Sider (fra-til)7-15
ISSN0001-6349
DOI
StatusUdgivet - jan. 2020

Fingeraftryk

Methadone
Publications
Guidelines
PubMed
Meta-Analysis
Pregnant Women
Randomized Controlled Trials
Mothers
Urine
Databases

Citer dette

@article{770c1feb1804469da9ea186716d0244e,
title = "Management and monitoring of opioid use in pregnancy",
abstract = "Opioid use during pregnancy has serious consequences for mother and baby. The true extent of the problem is unknown and there is a need for better screening. Existing guidelines with respect to the management of pregnant women with opioid use are based on limited evidence. To improve recommendations for optimal identification, management, and treatment, publications on opioids in pregnancy were reviewed. Published literature from 2007 to 2017 was searched in PubMed, Cochrane and Embase databases. The review employed 60 publications from 210 studies identified, that were of varying quality and included randomized controlled trials, systematic reviews, meta-analyses, and Cochrane reviews. The prevalence of opioid use in pregnancy is underestimated. Screening by urine testing and self-reporting is acceptable to identify fetal exposure. To minimize risk, opioid agonist pharmacotherapy should replace the continued use of opioids or detoxification. Current guidelines recommend methadone and buprenorphine equally. However, recent studies indicate that buprenorphine has advantages over methadone. Accordingly, we suggest buprenorphine as first-line therapy. Future studies should elaborate on better objective screening methods to prevent the consequences of fetomaternal opioid exposure.",
keywords = "Buprenorphine, methadone, neonatal abstinence syndrome, opioid, opioid abuse, opioid use disorder, pregnancy, substance abuse",
author = "Rausgaard, {Nete Lundager Klokker} and Ibsen, {Inge Olga} and J{\o}rgensen, {Jan Stener} and Lamont, {Ronald Francis} and Pernille Ravn",
year = "2020",
month = "1",
doi = "10.1111/aogs.13677",
language = "English",
volume = "99",
pages = "7--15",
journal = "Acta Obstetricia et Gynecologica Scandinavica",
issn = "0001-6349",
publisher = "JohnWiley & Sons Ltd.",
number = "1",

}

Management and monitoring of opioid use in pregnancy. / Rausgaard, Nete Lundager Klokker; Ibsen, Inge Olga; Jørgensen, Jan Stener; Lamont, Ronald Francis; Ravn, Pernille.

I: Acta Obstetricia et Gynecologica Scandinavica, Bind 99, Nr. 1, 01.2020, s. 7-15.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

TY - JOUR

T1 - Management and monitoring of opioid use in pregnancy

AU - Rausgaard, Nete Lundager Klokker

AU - Ibsen, Inge Olga

AU - Jørgensen, Jan Stener

AU - Lamont, Ronald Francis

AU - Ravn, Pernille

PY - 2020/1

Y1 - 2020/1

N2 - Opioid use during pregnancy has serious consequences for mother and baby. The true extent of the problem is unknown and there is a need for better screening. Existing guidelines with respect to the management of pregnant women with opioid use are based on limited evidence. To improve recommendations for optimal identification, management, and treatment, publications on opioids in pregnancy were reviewed. Published literature from 2007 to 2017 was searched in PubMed, Cochrane and Embase databases. The review employed 60 publications from 210 studies identified, that were of varying quality and included randomized controlled trials, systematic reviews, meta-analyses, and Cochrane reviews. The prevalence of opioid use in pregnancy is underestimated. Screening by urine testing and self-reporting is acceptable to identify fetal exposure. To minimize risk, opioid agonist pharmacotherapy should replace the continued use of opioids or detoxification. Current guidelines recommend methadone and buprenorphine equally. However, recent studies indicate that buprenorphine has advantages over methadone. Accordingly, we suggest buprenorphine as first-line therapy. Future studies should elaborate on better objective screening methods to prevent the consequences of fetomaternal opioid exposure.

AB - Opioid use during pregnancy has serious consequences for mother and baby. The true extent of the problem is unknown and there is a need for better screening. Existing guidelines with respect to the management of pregnant women with opioid use are based on limited evidence. To improve recommendations for optimal identification, management, and treatment, publications on opioids in pregnancy were reviewed. Published literature from 2007 to 2017 was searched in PubMed, Cochrane and Embase databases. The review employed 60 publications from 210 studies identified, that were of varying quality and included randomized controlled trials, systematic reviews, meta-analyses, and Cochrane reviews. The prevalence of opioid use in pregnancy is underestimated. Screening by urine testing and self-reporting is acceptable to identify fetal exposure. To minimize risk, opioid agonist pharmacotherapy should replace the continued use of opioids or detoxification. Current guidelines recommend methadone and buprenorphine equally. However, recent studies indicate that buprenorphine has advantages over methadone. Accordingly, we suggest buprenorphine as first-line therapy. Future studies should elaborate on better objective screening methods to prevent the consequences of fetomaternal opioid exposure.

KW - Buprenorphine

KW - methadone

KW - neonatal abstinence syndrome

KW - opioid

KW - opioid abuse

KW - opioid use disorder

KW - pregnancy

KW - substance abuse

U2 - 10.1111/aogs.13677

DO - 10.1111/aogs.13677

M3 - Review

C2 - 31197827

AN - SCOPUS:85068531014

VL - 99

SP - 7

EP - 15

JO - Acta Obstetricia et Gynecologica Scandinavica

JF - Acta Obstetricia et Gynecologica Scandinavica

SN - 0001-6349

IS - 1

ER -