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Neonatal Outcomes after Combined Opioid and Nicotine Exposure in Utero: A Scoping Review

Author

Listed:
  • Krystyna R. Isaacs

    (Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA
    Co-Authors.)

  • Sravanthi Atreyapurapu

    (Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA
    Co-Authors.)

  • Amal H. Alyusuf

    (Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA)

  • David M. Ledgerwood

    (Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI 48201, USA)

  • Loretta P. Finnegan

    (Executive Officer of the College on Problems of Drug Dependence and Finnegan Consulting, Philadelphia, PA 19140, USA)

  • Katie H. K. Chang

    (Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA)

  • Tony X. Ma

    (Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA)

  • Yukiko Washio

    (Substance Use, Gender and Applied Research, RTI International, 3040 E Cornwallis Rd, Durham, NC 27709, USA
    Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Lewis Katz School of Medicine, 3500 N Broad St, Philadelphia, PA 19140, USA)

Abstract

Background: The majority of women who are pregnant with opioid use disorder (OUD) also smoke tobacco but are rarely offered tobacco cessation counseling. While the effects of exposure to opioids and nicotine in utero are well-understood separately, understanding the impact of the combined exposure to these substances on neonatal outcomes is lacking. Methods: A scoping review was conducted using PubMed and Scopus databases for studies addressing the combined exposure to opioids and nicotine during pregnancy published between 1 January 1980 and 9 July 2019. A total of 29 papers met the eligibility criteria for inclusion, with nine being identified as clinical trials (three from the MOTHER study) and two as secondary data analysis of clinical trial data. Results: Neonatal outcomes for infants who had a combined exposure to opioids and nicotine in utero indicated a reduction in birth weight and birth length. Findings in infants exposed to both nicotine and opioids were mixed with regard to the duration of neonatal abstinence syndrome (NAS), the likelihood of treatment for NAS, doses of medicine used to treat NAS, and NAS scores when compared with infants who had opioid exposure without nicotine. Conclusions: The combined exposure to nicotine and opioids during pregnancy may lead to a reduction in neonatal birth weight and birth length and more severe NAS signs, compared with opioid use alone, but more research is necessary to identify the minimum dosage and length of nicotine exposure to accurately predict these outcomes.

Suggested Citation

  • Krystyna R. Isaacs & Sravanthi Atreyapurapu & Amal H. Alyusuf & David M. Ledgerwood & Loretta P. Finnegan & Katie H. K. Chang & Tony X. Ma & Yukiko Washio, 2021. "Neonatal Outcomes after Combined Opioid and Nicotine Exposure in Utero: A Scoping Review," IJERPH, MDPI, vol. 18(19), pages 1-15, September.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:10215-:d:645366
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Agnieszka Genowska & Radosław Motkowski & Vaiva Strukcinskaite & Paweł Abramowicz & Jerzy Konstantynowicz, 2022. "Inequalities in Birth Weight in Relation to Maternal Factors: A Population-Based Study of 3,813,757 Live Births," IJERPH, MDPI, vol. 19(3), pages 1-16, January.

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