Opioid Abuse in Pregnancy

Epidemiology: 0.2% of pregnant women use heroin > methadone; 75,000 neonates/year are exposed to opioid abuse in utero and 6090% manifest neonatal withdrawal syndrome (NWS).

Maternal complications: Hepatitis, sepsis, septic emboli, subacute bacterial endocarditis, STDs, AIDS.

OB comp: Spontaneous abortion (SAB), premature delivery, stillbirth.

Neonatal complications: Small for gestational age.

Neonatal withdrawal syndrome (NWS): Occurs within 24 hours for heroin, but delayed for days with methadone abuse; increased incidence of sudden infant death syndrome (SIDS) for 2 years.

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