Increase Awareness of Risks of SUD on the Baby
Introductory Paragraph
Opioid use during pregnancy can affect women and their babies. Women may use opioids as prescribed, may misuse prescription opioids, may use illicit opioids such as heroin, or may use opioids (opioid agonists and/or antagonists) as part of medication-assisted treatment for opioid use disorder. Regardless of the reason, women who use opioids during pregnancy should be aware of the possible risks during pregnancy, as well as her potential treatment options for opioid use disorder.
Key Information
Opioid Use During Pregnancy
Neonatal Abstinence Syndrome (NAS)
Opioid use and medication assisted treatment for opioid use disorder during pregnancy can lead to neonatal abstinence syndrome (NAS) in some newborns. NAS is a group of conditions that can occur when newborns withdraw from certain substances including opioids that they were exposed to before birth. Withdrawal caused by opioids during the first 28 days of life is sometimes also called neonatal opioid withdrawal syndrome (NOWS). Withdrawal symptoms in newborns usually occur 48–72 hours after birth. Drug withdrawal symptoms may include:
- Tremors (trembling)
- Irritability, including excessive or high-pitched crying
- Sleep problems
- Hyperactive reflexes
- Seizures
- Yawning, stuffy nose, or sneezing
- Poor feeding and sucking
- Vomiting
- Loose stools and dehydration
- Increased sweating
The symptoms a newborn might experience, and how severe the symptoms will be, depend on different factors. Some factors include the type and amount of substance the newborn was exposed to before birth, the last time a substance was used, whether the baby is born full-term or premature, and if the newborn was exposed to more than one substance before birth.
Birth Outcomes Associated with Opioid Use During Pregnancy
Infants exposed to opioids during pregnancy might be more likely to
- Be born preterm (born before 37 weeks of pregnancy);
- Have poor fetal growth;
- Have longer hospital stays after birth;
- Be re-hospitalized within 30 days of being born; and
- Possibly be born with birth defects.
Longer-Term Developmental Outcomes
There is limited information about longer-term outcomes of children exposed to opioids prenatally, including those with or without NAS. Not all babies exposed to opioids during pregnancy experience signs of NAS, but they may still have longer-term outcomes not obvious at birth. Results from a recent studyexternal icon suggest that children with NAS were more likely to have a developmental delay or speech or language impairment in early childhood, compared with children without NAS. It is not clear if these impacts are due to opioids specifically, other substance exposures, or other environmental influences. Findingsexternal icon about long-term outcomes of children exposed to opioids during pregnancy are inconsistent. More research is needed to better understand the spectrum of possible outcomes related to opioid exposure during pregnancy.
Relevant Research
In this section, please capture any recent findings, reports, or data on the topic. Please also highlight any gaps or existing disparities. Please include references and links to the information so that we may add a footnote for the reader to find further information. Do we have any available research about discriminatory practices? Is there information about the value of access to educational opportunities?
Impactful Federal, State, and Local Policies
Please list any federal, state, or local laws, policies, or regulations that support this topic or ones that could be a possible barrier. Are there laws or policies other states should know about and replicate for success?
Available Tools and Resources
Supporting Mothers and Infants Impacted by Perinatal Opioid Use: A Cross-Sector Assessment[1]-A collaborative assessment funded from the Center for Drug Policy and Enforcement at the University of Baltimore through the Community-level intervention initiative. It was noted the two main objectives of the report include:
- to provide the results of the assessment and recommendations
- to provide information on our process, the lessons we learned along the way, and resources that may help others engaged in similar projects/collaboratives.
Promising Practices
Please link to any best practice models or case studies that highlight creative/innovative or successful efforts in support of this strategy. Is there a community that does a really good job in this area that other communities should replicate? Please write a brief description and provide a link.