RT Journal Article
SR Electronic
T1 Narcotic tapering in pregnancy using long-acting morphine
JF Canadian Family Physician
JO Can Fam Physician
FD The College of Family Physicians of Canada
SP e88
OP e95
VO 61
IS 2
A1 Roisin Dooley
A1 Joe Dooley
A1 Irwin Antone
A1 John Guilfoyle
A1 Lianne Gerber-Finn
A1 Kara Kakekagumick
A1 Helen Cromarty
A1 Wilma Hopman
A1 Jill Muileboom
A1 Nicole Brunton
A1 Len Kelly
YR 2015
UL http://www.cfp.ca/content/61/2/e88.abstract
AB 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.