The current opioid epidemic has particular importance for pregnant women with opioid use disorder (OUD). Heroin addiction, use and misuse of prescription opioids for treatment of pain, and medication-assisted treatment are all increasing.1 Between 1999 and 2014, the number of pregnant women using opioids in the United States increased significantly from 1.5 to 6.5 per 1000 deliveries.2 In utero opioid exposure can cause neonatal abstinence syndrome (NAS), a disorder characterized by central nervous system and autonomic nervous system dysfunction. Despite the increasing frequency of NAS, key knowledge gaps exist including uncertainty about whether, when, and how to treat these neonates, how to wean medications, and the optimal agent(s) to use.1 The short- and long-term efficacy and safety of various maternal and neonatal treatments are unknown, and additional research is needed.
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Davis JM, Yao L, Bierer BE. Protecting Pregnant Women With Substance Use Disorders and Their Neonates Participating in Research. JAMA. Published online July 12, 2019322(7):609–610. doi:10.1001/jama.2019.9002
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