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In Utero Drug Withdrawal

MedGen UID:
769756
•Concept ID:
C3641116
•
Mental or Behavioral Dysfunction

Definition

Drug withdrawal symptoms in a fetus following maternal discontinuation or reduction of use of one or more addictive substance(s) that have caused fetal physiological dependence. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVIn Utero Drug Withdrawal

Professional guidelines

PubMed

Opioid Treatment for Neonatal Opioid Withdrawal Syndrome: Current Challenges and Future Approaches.
McPhail BT, Emoto C, Butler D, Fukuda T, Akinbi H, Vinks AA
J Clin Pharmacol 2021 Jul;61(7):857-870. Epub 2021 Feb 1 doi: 10.1002/jcph.1811. PMID: 33382111
Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.
Wachman EM, Schiff DM, Silverstein M
JAMA 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. PMID: 29614184
Neonatal Abstinence Syndrome Management: A Review of Recent Evidence.
Grossman M, Seashore C, Holmes AV
Rev Recent Clin Trials 2017;12(4):226-232. doi: 10.2174/1574887112666170816144818. PMID: 28814260

Recent clinical studies

Etiology

Family planning considerations in people with multiple sclerosis.
Krysko KM, Dobson R, Alroughani R, Amato MP, Bove R, Ciplea AI, Fragoso Y, Houtchens M, Jokubaitis VG, Magyari M, Abdelnasser A, Padma V, Thiel S, Tintore M, Vukusic S, Hellwig K
Lancet Neurol 2023 Apr;22(4):350-366. doi: 10.1016/S1474-4422(22)00426-4. PMID: 36931808
Prenatal Opioid Exposure and Neurodevelopmental Outcomes.
Lee JJ, Saraiya N, Kuzniewicz MW
J Neurosurg Anesthesiol 2023 Jan 1;35(1):142-146. Epub 2022 Dec 6 doi: 10.1097/ANA.0000000000000876. PMID: 36745179
Evidence-Based Contraception: Common Questions and Answers.
Paradise SL, Landis CA, Klein DA
Am Fam Physician 2022 Sep;106(3):251-259. PMID: 36126006
The placenta as a target of opioid drugs†.
Rosenfeld CS
Biol Reprod 2022 Apr 26;106(4):676-686. doi: 10.1093/biolre/ioac003. PMID: 35024817Free PMC Article
Tibolone: a review.
Albertazzi P, Di Micco R, Zanardi E
Maturitas 1998 Nov 16;30(3):295-305. doi: 10.1016/s0378-5122(98)00059-0. PMID: 9881330

Diagnosis

Family planning considerations in people with multiple sclerosis.
Krysko KM, Dobson R, Alroughani R, Amato MP, Bove R, Ciplea AI, Fragoso Y, Houtchens M, Jokubaitis VG, Magyari M, Abdelnasser A, Padma V, Thiel S, Tintore M, Vukusic S, Hellwig K
Lancet Neurol 2023 Apr;22(4):350-366. doi: 10.1016/S1474-4422(22)00426-4. PMID: 36931808
The placenta as a target of opioid drugs†.
Rosenfeld CS
Biol Reprod 2022 Apr 26;106(4):676-686. doi: 10.1093/biolre/ioac003. PMID: 35024817Free PMC Article
Outcome reporting in neonates experiencing withdrawal following opioid exposure in pregnancy: a systematic review.
Shan F, MacVicar S, Allegaert K, Offringa M, Jansson LM, Simpson S, Moulsdale W, Kelly LE
Trials 2020 Mar 12;21(1):262. doi: 10.1186/s13063-020-4183-9. PMID: 32164782Free PMC Article
Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.
Wachman EM, Schiff DM, Silverstein M
JAMA 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. PMID: 29614184
Paroxetine toxicity in a newborn after in utero exposure: clinical symptoms correlate with serum levels.
Knoppert DC, Nimkar R, Principi T, Yuen D
Ther Drug Monit 2006 Feb;28(1):5-7. doi: 10.1097/01.ftd.0000187971.95000.25. PMID: 16418684

Therapy

Maternal opioid use disorder: Placental transcriptome analysis for neonatal opioid withdrawal syndrome.
Radhakrishna U, Nath SK, Vishweswaraiah S, Uppala LV, Forray A, Muvvala SB, Mishra NK, Southekal S, Guda C, Govindamangalam H, Vargas D, Gardella WG, Crist RC, Berrettini WH, Metpally RP, Bahado-Singh RO
Genomics 2021 Nov;113(6):3610-3617. Epub 2021 Aug 3 doi: 10.1016/j.ygeno.2021.08.001. PMID: 34352367
Opioid Use in Pregnancy.
Tobon AL, Habecker E, Forray A
Curr Psychiatry Rep 2019 Nov 16;21(12):118. doi: 10.1007/s11920-019-1110-4. PMID: 31734808Free PMC Article
Pharmacological and non-pharmacological treatments for the Neonatal Abstinence Syndrome (NAS).
Mangat AK, Schmölzer GM, Kraft WK
Semin Fetal Neonatal Med 2019 Apr;24(2):133-141. Epub 2019 Feb 5 doi: 10.1016/j.siny.2019.01.009. PMID: 30745219Free PMC Article
Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.
Wachman EM, Schiff DM, Silverstein M
JAMA 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. PMID: 29614184
Pharmacotherapy for Neonatal Abstinence Syndrome: Choosing the Right Opioid or No Opioid at All.
McPherson C
Neonatal Netw 2016;35(5):314-20. doi: 10.1891/0730-0832.35.5.314. PMID: 27636696

Prognosis

Duration and Timing of In Utero Opioid Exposure and Incidence of Neonatal Withdrawal Syndrome.
Wang Y, Berger L, Durrance C, Kirby RS, Kuo D, Pac J, Ehrenthal DB
Obstet Gynecol 2023 Sep 1;142(3):603-611. doi: 10.1097/AOG.0000000000005289. PMID: 37548391Free PMC Article
A review of pregnancy-induced changes in opioid pharmacokinetics, placental transfer, and fetal exposure: Towards fetomaternal physiologically-based pharmacokinetic modeling to improve the treatment of neonatal opioid withdrawal syndrome.
van Hoogdalem MW, Wexelblatt SL, Akinbi HT, Vinks AA, Mizuno T
Pharmacol Ther 2022 Jun;234:108045. Epub 2021 Nov 20 doi: 10.1016/j.pharmthera.2021.108045. PMID: 34813863
Opioid Treatment for Neonatal Opioid Withdrawal Syndrome: Current Challenges and Future Approaches.
McPhail BT, Emoto C, Butler D, Fukuda T, Akinbi H, Vinks AA
J Clin Pharmacol 2021 Jul;61(7):857-870. Epub 2021 Feb 1 doi: 10.1002/jcph.1811. PMID: 33382111
Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.
Wachman EM, Schiff DM, Silverstein M
JAMA 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. PMID: 29614184
Short- and long-term complications of in utero exposure to lamotrigine.
Cohen-Israel M, Berger I, Martonovich EY, Klinger G, Stahl B, Linder N
Br J Clin Pharmacol 2018 Jan;84(1):189-194. Epub 2017 Oct 22 doi: 10.1111/bcp.13437. PMID: 29044597Free PMC Article

Clinical prediction guides

Neonatal Withdrawal Syndrome following Late in utero Exposure to Selective Serotonin Reuptake Inhibitors: A Systematic Review and Meta-Analysis of Observational Studies.
Wang J, Cosci F
Psychother Psychosom 2021;90(5):299-307. Epub 2021 May 10 doi: 10.1159/000516031. PMID: 33971648
Outcome reporting in neonates experiencing withdrawal following opioid exposure in pregnancy: a systematic review.
Shan F, MacVicar S, Allegaert K, Offringa M, Jansson LM, Simpson S, Moulsdale W, Kelly LE
Trials 2020 Mar 12;21(1):262. doi: 10.1186/s13063-020-4183-9. PMID: 32164782Free PMC Article
Pharmacological and non-pharmacological treatments for the Neonatal Abstinence Syndrome (NAS).
Mangat AK, Schmölzer GM, Kraft WK
Semin Fetal Neonatal Med 2019 Apr;24(2):133-141. Epub 2019 Feb 5 doi: 10.1016/j.siny.2019.01.009. PMID: 30745219Free PMC Article
Neonatal Abstinence Syndrome: Advances in Diagnosis and Treatment.
Wachman EM, Schiff DM, Silverstein M
JAMA 2018 Apr 3;319(13):1362-1374. doi: 10.1001/jama.2018.2640. PMID: 29614184
Endometrial response in post-menopausal women during treatment with percutaneous 17 beta-oestradiol opposed by oral progesterone.
Holst J, Cajander S, von Schoultz B
Maturitas 1986 Oct;8(3):201-7. doi: 10.1016/0378-5122(86)90027-7. PMID: 3784916

Recent systematic reviews

Neonatal Withdrawal Syndrome following Late in utero Exposure to Selective Serotonin Reuptake Inhibitors: A Systematic Review and Meta-Analysis of Observational Studies.
Wang J, Cosci F
Psychother Psychosom 2021;90(5):299-307. Epub 2021 May 10 doi: 10.1159/000516031. PMID: 33971648
Progestogen-releasing intrauterine systems for heavy menstrual bleeding.
Bofill Rodriguez M, Lethaby A, Jordan V
Cochrane Database Syst Rev 2020 Jun 12;6(6):CD002126. doi: 10.1002/14651858.CD002126.pub4. PMID: 32529637Free PMC Article
Outcome reporting in neonates experiencing withdrawal following opioid exposure in pregnancy: a systematic review.
Shan F, MacVicar S, Allegaert K, Offringa M, Jansson LM, Simpson S, Moulsdale W, Kelly LE
Trials 2020 Mar 12;21(1):262. doi: 10.1186/s13063-020-4183-9. PMID: 32164782Free PMC Article
Hormone therapy in postmenopausal women and risk of endometrial hyperplasia.
Furness S, Roberts H, Marjoribanks J, Lethaby A
Cochrane Database Syst Rev 2012 Aug 15;2012(8):CD000402. doi: 10.1002/14651858.CD000402.pub4. PMID: 22895916Free PMC Article
Hormone therapy in postmenopausal women and risk of endometrial hyperplasia.
Furness S, Roberts H, Marjoribanks J, Lethaby A, Hickey M, Farquhar C
Cochrane Database Syst Rev 2009 Apr 15;(2):CD000402. doi: 10.1002/14651858.CD000402.pub3. PMID: 19370558

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