Narcotic tapering in pregnancy using long-acting morphine: an 18-month prospective cohort study in northwestern Ontario.

Abstract

OBJECTIVE:

To document the management of and outcomes for patients receiving narcotic replacement and tapering with long-acting morphine preparations during pregnancy.

DESIGN:

A prospective cohort study over 18 months.

SETTING:

Northwestern Ontario.

PARTICIPANTS:

All 600 births at Meno Ya Win Health Centre in Sioux Lookout, Ont, from January 1, 2012, to June 30, 2013, including 166 narcotic-exposed pregnancies.

INTERVENTION:

Narcotic replacement and tapering of narcotic use with long-acting morphine preparations.

MAIN OUTCOME MEASURES:

Prenatal management of maternal narcotic use, incidence of neonatal abstinence syndrome, and other neonatal outcomes.

RESULTS:

The incidence of neonatal abstinence syndrome fell significantly to 18.1% of pregnancies exposed to narcotics (from 29.5% in a previous 2010 study, P = .003) among patients using narcotic replacement and tapering with long-acting morphine preparations. Neonatal outcomes were otherwise equivalent to those of the nonexposed pregnancies.

CONCLUSION:

In many patients, long-acting morphine preparations can be safely used and tapered in pregnancy, with a subsequent decrease in observed neonatal withdrawal symptoms.

• Authors: Roisin Dooley, Joe Dooley, Irwin Antone, John Guilfoyle, Lianne Gerber-Finn, Kara Kakekagumick, Helen Cromarty, Wilma Hopman, Jill Muileboom, Nicole Brunton, Len Kelly
• Journal: Canadian family physician Medecin de famille canadien (Can Fam Physician) Vol. 61 Issue 2 Pg. e88-95 (Feb 2015) ISSN: 1715-5258 [Electronic] Canada
• PMID: 25821873 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Delayed-Action Preparations
• Narcotics
• Morphine

Topics

• Adult
• Delayed-Action Preparations (administration & dosage)
• Female
• Humans
• Incidence
• Infant, Newborn
• Male
• Maternal-Fetal Exchange (drug effects)
• Morphine (administration & dosage, toxicity)
• Narcotics (administration & dosage, toxicity)
• Neonatal Abstinence Syndrome (epidemiology, etiology)
• Ontario (epidemiology)
• Opioid-Related Disorders (ethnology)
• Pregnancy
• Pregnancy Complications (chemically induced, epidemiology)
• Prospective Studies
• Young Adult