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Obstetric pain medication and eventual adult amphetamine addiction in offspring
B Jacobson1, K Nyberg, G Eklund
1Department of Medical Engineering, Karolinska Institutet, Stockholm, Sweden.
Insights
Obstetric pain medication, specifically nitrous oxide, may increase the risk of amphetamine addiction in children. Longer exposure times during birth correlated with higher addiction risks in later life.
Area of Science:
- Perinatal Medicine
- Addiction Research
- Neuroscience
Background:
- Obstetric analgesia is commonly used during labor.
- The potential long-term effects of medications administered during childbirth on offspring are not fully understood.
Purpose of the Study:
- To investigate the association between obstetric analgesia, particularly nitrous oxide, and the risk of amphetamine addiction in offspring.
- To determine if the duration of nitrous oxide administration during labor influences the risk of later-life amphetamine addiction.
Main Methods:
- A retrospective study comparing 200 amphetamine addicts with controls.
- Matched sibling comparison using logistic regression to analyze natal variables, including nitrous oxide exposure.
- Statistical analysis of the correlation between duration of nitrous oxide administration and amphetamine addiction risk.
Main Results:
- A higher proportion of amphetamine addicts were born in hospitals with high pain medication use.
- Increased risk of amphetamine addiction was associated with longer durations of nitrous oxide administration during labor (≥4.5 hours vs. ≤0.25 hours).
- The estimated risk was 5.6 times greater for longer exposure, with potential underestimation.
Conclusions:
- Nitrous oxide administration during labor may be a risk factor for developing amphetamine addiction later in life.
- The duration of nitrous oxide exposure appears to be a significant factor in this risk.
- Local or regional anesthesia may be preferable to general anesthesia due to reduced placental drug transfer.
Abstract:
Our purpose was to investigate whether obstetric analgesia, particularly by nitrous oxide, constitutes a risk that the infant might develop amphetamine addiction in later life. Of 200 current amphetamine addicts born between 1945 and 1966 in Stockholm, proportionately more were born at hospitals where pain medication had been administered in large doses (p less than 0.05). A blind matched comparison was made between 73 addicts and 109 non-addicted siblings by logistic regression, in which nitrous oxide administration was tested in competition with 12 other natal variables as possible confounders. The risk for amphetamine drug addiction in offspring was found to increase with duration of intermittent administration of pure nitrous oxide, i.e. it was estimated to be 5.6 times greater (95% confidence intervals 1.6-16.9, p = 0.005) when nitrous oxide had been given for greater than or equal to 4.5 h vis-à-vis less than or equal to 0.25 h. Calculated risks are probably underestimates. Results can be explained as an effect of imprinting. It is concluded that local or regional anesthesia are preferable to general anesthesia which allows substantial amounts of drugs to cross the placenta.