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Narcotic-exposed neonates in a First Nations population in northwestern Ontario: incidence and implications.
Can Fam Physician. 2011 Nov; 57(11):e441-7.CF

Abstract

OBJECTIVE

To document the incidence of neonatal abstinence syndrome (NAS) and the rate of narcotic use during pregnancy in northwestern Ontario, where narcotic abuse is a growing social and medical problem.

DESIGN

Retrospective chart review.

SETTING

The Sioux Lookout Meno Ya Win Health Centre catchment area in northwestern Ontario.

PARTICIPANTS

Mothers and neonates for the 482 live births that took place in the 18-month study period (January 2009 to June 2010).

MAIN OUTCOME MEASURES

Maternal drug use and neonatal outcomes were documented.

RESULTS

The incidence of narcotic (oxycodone) abuse during pregnancy increased from a low of 8.4% at the beginning of the study period to a high of 17.2% by mid-2010. Narcotic-using mothers were more likely to also use nicotine and alcohol, to have premature deliveries, and to be episodic users. Narcotic-exposed neonates experienced NAS 29.5% of the time; daily maternal use was associated with a higher rate of NAS (66.0%). While all infants roomed in with their mothers, exposed infants were more likely to require transfer to a tertiary care nursery. Infants with severe NAS were treated with oral morphine and had significantly longer hospital stays compared with the entire cohort (4.5 vs 1.5 days, P = .004). Narcotic abuse during pregnancy in our region is not currently associated with increased rates of HIV or hepatitis C infection, as intravenous route of administration is less common at present than intranasal and oral ingestion.

CONCLUSION

Narcotic abuse during pregnancy is a considerable problem in First Nations communities in northwestern Ontario. Community-based initiatives need to be developed to address this issue, and medical and nursing staff need to develop surveillance, assessment, and therapeutic responses. Passive neonatal addiction and withdrawal result from maternal narcotic use during pregnancy. Rates of opioid use among pregnant Canadian women are unknown.

Authors+Show Affiliations

Division of Clinical Sciences, Northern Ontario School of Medicine, Sioux Lookout, Ont. lkelly@mcmaster.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22084474

Citation

Kelly, Len, et al. "Narcotic-exposed Neonates in a First Nations Population in Northwestern Ontario: Incidence and Implications." Canadian Family Physician Medecin De Famille Canadien, vol. 57, no. 11, 2011, pp. e441-7.
Kelly L, Dooley J, Cromarty H, et al. Narcotic-exposed neonates in a First Nations population in northwestern Ontario: incidence and implications. Can Fam Physician. 2011;57(11):e441-7.
Kelly, L., Dooley, J., Cromarty, H., Minty, B., Morgan, A., Madden, S., & Hopman, W. (2011). Narcotic-exposed neonates in a First Nations population in northwestern Ontario: incidence and implications. Canadian Family Physician Medecin De Famille Canadien, 57(11), e441-7.
Kelly L, et al. Narcotic-exposed Neonates in a First Nations Population in Northwestern Ontario: Incidence and Implications. Can Fam Physician. 2011;57(11):e441-7. PubMed PMID: 22084474.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Narcotic-exposed neonates in a First Nations population in northwestern Ontario: incidence and implications. AU - Kelly,Len, AU - Dooley,Joe, AU - Cromarty,Helen, AU - Minty,Bryanne, AU - Morgan,Alanna, AU - Madden,Sharen, AU - Hopman,Wilma, PY - 2011/11/16/entrez PY - 2011/11/16/pubmed PY - 2012/4/11/medline SP - e441 EP - 7 JF - Canadian family physician Medecin de famille canadien JO - Can Fam Physician VL - 57 IS - 11 N2 - OBJECTIVE: To document the incidence of neonatal abstinence syndrome (NAS) and the rate of narcotic use during pregnancy in northwestern Ontario, where narcotic abuse is a growing social and medical problem. DESIGN: Retrospective chart review. SETTING: The Sioux Lookout Meno Ya Win Health Centre catchment area in northwestern Ontario. PARTICIPANTS: Mothers and neonates for the 482 live births that took place in the 18-month study period (January 2009 to June 2010). MAIN OUTCOME MEASURES: Maternal drug use and neonatal outcomes were documented. RESULTS: The incidence of narcotic (oxycodone) abuse during pregnancy increased from a low of 8.4% at the beginning of the study period to a high of 17.2% by mid-2010. Narcotic-using mothers were more likely to also use nicotine and alcohol, to have premature deliveries, and to be episodic users. Narcotic-exposed neonates experienced NAS 29.5% of the time; daily maternal use was associated with a higher rate of NAS (66.0%). While all infants roomed in with their mothers, exposed infants were more likely to require transfer to a tertiary care nursery. Infants with severe NAS were treated with oral morphine and had significantly longer hospital stays compared with the entire cohort (4.5 vs 1.5 days, P = .004). Narcotic abuse during pregnancy in our region is not currently associated with increased rates of HIV or hepatitis C infection, as intravenous route of administration is less common at present than intranasal and oral ingestion. CONCLUSION: Narcotic abuse during pregnancy is a considerable problem in First Nations communities in northwestern Ontario. Community-based initiatives need to be developed to address this issue, and medical and nursing staff need to develop surveillance, assessment, and therapeutic responses. Passive neonatal addiction and withdrawal result from maternal narcotic use during pregnancy. Rates of opioid use among pregnant Canadian women are unknown. SN - 1715-5258 UR - https://www.unboundmedicine.com/medline/citation/22084474/Narcotic_exposed_neonates_in_a_First_Nations_population_in_northwestern_Ontario:_incidence_and_implications_ L2 - http://www.cfp.ca/cgi/pmidlookup?view=long&pmid=22084474 DB - PRIME DP - Unbound Medicine ER -