Opioids in the parturient with chronic nonmalignant pain: A retrospective review

Ibrahim Hadi, MD, FRCPC, Orlando da Silva, MD, FRCPC, Renato Natale, MD, FRCSC, David Boyd, MD, FRCPC, Patricia K. Morley-Forster, MD, FRCPC


The purpose of this research was to determine the neonatal outcomes of women who had been taking medically prescribed opioids throughout their pregnancy. A retrospective case study was done of 15 pregnancies associated with maternal opiate use between January 1, 1999, and September 30, 2002. Two cases were excluded due to coaddiction. Neonatal data were collected including gestational age, head circumference, length, birth weight, Apgar score at one and five minutes, details of resuscitation required, and Neonatal Abstinence Score. There were 13 pregnancies, which resulted in 13 live births; opioids prescribed included oxycodone, codeine, meperidine, fentanyl, dilaudid, morphine, and methadone. There were four babies with one-minute Apgar score = 5, and two babies with five-minute Apgar score = 5. It was concluded that neonatal growth markers in this population were within normal limits as plotted on the standard growth and development record of Gairdner-Pearson. Five out of 13 (38.5 percent) neonates were diagnosed with opioid discontinuation syndrome.


opioids, prescription, pain, pregnancy, neonatal development

Full Text:



Portenoy RK: Opioid therapy for chronic non-malignant pain. A review of the critical issues. J Pain Symptom Manage. 1996; 11: 203-217.

Zenz M, Strumpf M, Tryba M: Long-term oral opioid therapy in patients with chronic nonmalignant pain. J Pain Symptom Manage. 1992; 7: 69-77.

Sinha C, Ohadike P, Carrick P: Neonatal outcome following maternal opiate use in late pregnancy. Int J Gynecol Obstet. 2001; 74: 241-246.

American Academy of Pediatrics Committee on Drugs: Neonatal withdrawal. Pediatrics. 1998; 101: 1079-1087.

Chasnoff IJ: Prenatal addiction: Consequences of intrauterine exposure of opiates and non-opiate drugs. In Chasnoff IJ (Ed.): Drug Use in Pregnancy: Mother and Child. Boston: MTP Press, 1986:52-63.

Rivers RPA: Neonatal opiate withdrawal. Arch Dis Child. 1986; 61: 1236-1239.

Albersheim S, Mackinnon M: Infants of substance using mothers: A Canadian survey. Pediatr Res. 1999; 33: 199.

Single E, Williams R, McKenzie D: Canadian profile: Alcohol, tobacco and other drugs 1995. Toronto: Addiction Research Foundation, 1995.

Finnegan LP: Neonatal abstinence. In Nelson NM (Ed.): Current Therapy in Neonatal-Perinatal Medicine. Toronto: BC Decker, 1985:262-270.

Coghlan D, Milner M, Clarke T, et al.: Neonatal abstinence syndrome. Irish Med J. 1999; 92: 232-233.

Vance JC, Chant DC, Tudehope DL, et al.: Infants born to narcotic dependent mothers: Physical growth patterns in the first 12 months of life. J Pediatr Child Health. 1997; 33: 504-508.

Davidson Ward SL, Bautisa D, Chan L, et al.: Sudden infant death syndrome in infants of drug abusing mothers. J Pediatr. 1990; 117: 876-887.

Sorensen HJ, Mortensen EL, Reinisch JM, et al.: Association between prenatal exposure to analgesics and risk of schizophrenia. Br J Psychiatr. 2004; 185: 366-371.

Gauthier SW, Bauer CR, Masinger DS, et al.: The Bayley scales of infant development. J Behav Pediatr. 1999; 20: 75-79.

Johnson HL, Glassman MB, Fiks KB, et al.: Resilient children: Individual differences in developmental outcome of children born to drug abusers. J Genet Psychol. 1990; 151: 523-539.

Lester BM, LaGasse L, Seifer R, et al.: The maternal lifestyle study: Effects of prenatal cocaine and/or opiate exposure on auditory brain response at one month. J Pediatr. 2003; 142(3): 279-285.

DOI: https://doi.org/10.5055/jom.2006.0005


  • There are currently no refbacks.