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Maternal and neonatal characteristics of a Canadian urban cohort receiving treatment for opioid use disorder during pregnancy

Part of: A Canadian perspective on DOHaD

Published online by Cambridge University Press:  16 August 2018

C. Miller Open the ORCID record for C. Miller [Opens in a new window] ,
D. Grynspan ,
L. Gaudet ,
E. Ferretti ,
S. Lawrence ,
F. Moretti ,
A. Lafreniere ,
A. McGee ,
S. Lattuca  and
A. Black
C. Miller
Affiliation:
Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
D. Grynspan
Affiliation:
Department of Pathology and Laboratory Medicine, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
L. Gaudet
Affiliation:
Department of Obstetrics and Gynecology, School of Epidemiology, Public Health and Preventive Medicine, Ottawa Hospital, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
E. Ferretti
Affiliation:
Department of Pediatrics, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada Department of Pediatrics, Division of Neonatology, Ottawa Hospital, Ottawa, Ontario, Canada Department of Pediatrics, Division of Neonatology, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
S. Lawrence
Affiliation:
Department of Pediatrics, Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
F. Moretti
Affiliation:
Department of Obstetrics and Gynecology, Ottawa Hospital, Ottawa, Ontario, Canada Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
A. Lafreniere
Affiliation:
Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada Department of Pathology and Laboratory Medicine, Ottawa Hospital, Ottawa, Ontario, Canada
A. McGee
Affiliation:
Department of Obstetrics and Gynecology, Ottawa Hospital, Ottawa, Ontario, Canada
S. Lattuca
Affiliation:
Department of Obstetrics and Gynecology, Ottawa Hospital, Ottawa, Ontario, Canada
A. Black
Affiliation:
Department of Obstetrics and Gynecology, Ottawa Hospital, Ottawa, Ontario, Canada Obstetrics and Gynecology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Abstract

The epidemic of prescription and non-prescription opioid misuse is of particular importance in pregnancy. The Society of Obstetricians and Gynaecologists of Canada currently recommends opioid replacement therapy with methadone or buprenorphine for opioid-dependent women during pregnancy. This vulnerable segment of the population has been shown to be at increased risk of blood-borne infectious diseases, nutritional insecurity and stress. The objective of this study was to describe an urban cohort of pregnant women on opioid replacement therapy and to evaluate potential effects on the fetus. A retrospective chart review of all women on opioid replacement therapy and their infants who delivered at The Ottawa Hospital General and Civic campuses between January 1, 2013 and March 24, 2017 was conducted. Data were collected on maternal characteristics, pregnancy outcomes, neonatal outcomes and corresponding placental pathology. Maternal comorbidities identified included high rates of infection, tobacco use and illicit substance use, as well as increased rates of placental abruption compared with national averages. Compared with national baseline averages, the mean neonatal birth weight was low, and the incidence of small for gestational age infants and congenital anomalies was high. The incidence of NAS was comparable with estimates from other studies of similar cohorts. Findings support existing literature that calls for a comprehensive interdisciplinary risk reduction approach including dietary, social, domestic, psychological and other supports to care for opioid-dependent women in pregnancy.

Keywords

neonateopioidplacentapregnancy
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 10 , Special Issue 1: Themed Issue: Canada / Indigenous Populations , February 2019 , pp. 132 - 137
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2018 

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