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Naloxone for opiate-exposed newborn infants
Thirimon Moe-Byrne1, Jennifer V E Brown, William McGuire
1Centre for Reviews and Dissemination, University of York, York, UK.
The Cochrane Database of Systematic Reviews
|March 2, 2013
Summary
Naloxone (naloxone) may improve breathing in newborns exposed to opiates, but evidence is insufficient to confirm benefits or safety for respiratory or neurological depression. Further randomized trials are needed to resolve these uncertainties.
Area of Science:
- Neonatal medicine
- Pharmacology
- Clinical trials
Background:
- Naloxone is an opiate antagonist used for neonatal cardiorespiratory or neurological depression due to intrauterine opiate exposure.
- The efficacy and safety of naloxone in this neonatal population remain unclear.
Purpose of the Study:
- To evaluate the effect of naloxone in newborn infants with in utero opiate exposure.
Main Methods:
- Systematic review of randomized controlled trials comparing naloxone to placebo or no treatment.
- Searched multiple databases (Cochrane, MEDLINE, EMBASE, etc.) and clinical trial registries up to June 2012.
- Data synthesized using risk ratios and weighted mean differences.
Main Results:
- Nine trials included infants exposed to maternal opiate analgesia; none specifically recruited infants with depression.
- Some evidence suggests naloxone may increase alveolar ventilation in the first six hours of life.
- Primary outcomes like neonatal unit admission and breastfeeding success were not assessed.
Conclusions:
- Current evidence is insufficient to determine naloxone's benefits for neonatal cardiorespiratory or neurological depression from intrauterine opiate exposure.
- Given safety concerns, naloxone use in this context should be limited to randomized controlled trials.
- Further research is needed to clarify the role of naloxone in neonatal opiate exposure.
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