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Progenitor-derived Oligodendrocyte Culture System from Human Fetal Brain
Published on: December 20, 2012
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Opioids affect the fetal brain: reframing the detoxification debate.
Steve N Caritis1, Ashok Panigrahy2
1Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Maternal-Fetal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
American Journal of Obstetrics and Gynecology
|July 20, 2019
Summary
Medication-assisted treatment is preferred for opioid use disorder in pregnant women. However, medically supervised withdrawal may be an option for some, despite concerns about fetal brain development and opioid exposure.
Area of Science:
- Neuroscience
- Obstetrics
- Pharmacology
Background:
- Opioid use disorder (OUD) in pregnancy presents complex treatment challenges.
- Medication-assisted treatment (MAT) is the recommended standard of care.
- Medically supervised withdrawal (MSW) is an alternative with debated outcomes.
Purpose of the Study:
- To evaluate the impact of opioids on the developing fetal brain.
- To inform treatment paradigms for pregnant women with OUD.
- To compare MAT and MSW in pregnant women with OUD.
Main Methods:
- Review of animal and human studies on opioid effects on brain tissue and in vivo.
- Analysis of neuroimaging data across the human lifespan.
- Examination of outcomes data for MAT and MSW in pregnancy.
Main Results:
- Opioids adversely affect fetal brain development, impacting myelinization, connectivity, and brain region size.
- Evidence suggests vulnerability in fronto-temporal-limbic and frontal-subcortical pathways.
- Long-term consequences of in utero opioid exposure on brain development are not fully understood.
Conclusions:
- A new care paradigm is needed, offering both MAT and MSW as options for select pregnant women.
- Both treatment approaches should integrate mental health and social support.
- Further research is crucial to optimize MSW protocols and understand long-term neurodevelopmental impacts.
Keywords:
MRIaccumbens areaamygdalaastrogliabrainstembuprenorphinecerebellumcerebral cortexdetoxificationfetal neurobiologymagnetic resonance imagingmedically supervised opioid withdrawalmedication-assisted treatmentmethadoneneural pathwaysoligodendrocytesopioid dose reduction or eliminationopioidspallidumputamensuperior and inferior longitudinal fasciculus and white matter
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