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Neonatal and longer term management following substance misuse in pregnancy

Helen Mactier1

  • 1Neonatal Unit, Princess Royal Maternity, 8-16, Alexandra Parade, Glasgow G31 2ER, United Kingdom; NHS Greater Glasgow and Clyde, United Kingdom; The University of Glasgow, United Kingdom.

Early Human Development
|October 12, 2013
PubMed

Substance misuse in pregnancy is not a new problem, but although impaired foetal growth and the risk of developing neonatal abstinence syndrome are widely appreciated, relatively little attention has been paid to longer term consequences for the infant. Available evidence indicates that prenatal exposure to opioids and other drugs of misuse is detrimental to the developing foetal brain; consistent with this, poor in utero head growth, delayed infant visual maturation and impaired general neurodevelopmental progress independent of social confounders are increasingly being recognised. This review considers current evidence and discusses best practice in the neonatal management and follow-up of affected babies. More studies are required to explore alternatives to methadone maintenance in pregnancy and to define optimal treatment for neonatal abstinence syndrome. All infants born to drug-misusing mothers must be considered vulnerable, even if they have not required treatment for neonatal abstinence syndrome.

Keywords:
BuprenorphineMethadoneNeonatal abstinence syndromeNeonateSubstance misuse in pregnancy

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