Neonatal Outcomes after Combined Opioid and Nicotine Exposure in Utero: A Scoping Review

Krystyna R. Isaacs, Sravanthi Atreyapurapu, Amal H. Alyusuf, David M. Ledgerwood, Loretta P. Finnegan, Katie H. K. Chang, Tony X. Ma and Yukiko Washio
Additional contact information
Krystyna R. Isaacs: Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA
Sravanthi Atreyapurapu: Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA
Amal H. Alyusuf: Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA
David M. Ledgerwood: Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI 48201, USA
Loretta P. Finnegan: Executive Officer of the College on Problems of Drug Dependence and Finnegan Consulting, Philadelphia, PA 19140, USA
Katie H. K. Chang: Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA
Tony X. Ma: Benten Technologies, 9408 Grant Ave Suite 206, Manassas, VA 20110, USA
Yukiko Washio: Substance Use, Gender and Applied Research, RTI International, 3040 E Cornwallis Rd, Durham, NC 27709, USA

IJERPH, 2021, vol. 18, issue 19, 1-15

Abstract: Background: The majority of women who are pregnant with opioid use disorder (OUD) also smoke tobacco but are rarely offered tobacco cessation counseling. While the effects of exposure to opioids and nicotine in utero are well-understood separately, understanding the impact of the combined exposure to these substances on neonatal outcomes is lacking. Methods: A scoping review was conducted using PubMed and Scopus databases for studies addressing the combined exposure to opioids and nicotine during pregnancy published between 1 January 1980 and 9 July 2019. A total of 29 papers met the eligibility criteria for inclusion, with nine being identified as clinical trials (three from the MOTHER study) and two as secondary data analysis of clinical trial data. Results: Neonatal outcomes for infants who had a combined exposure to opioids and nicotine in utero indicated a reduction in birth weight and birth length. Findings in infants exposed to both nicotine and opioids were mixed with regard to the duration of neonatal abstinence syndrome (NAS), the likelihood of treatment for NAS, doses of medicine used to treat NAS, and NAS scores when compared with infants who had opioid exposure without nicotine. Conclusions: The combined exposure to nicotine and opioids during pregnancy may lead to a reduction in neonatal birth weight and birth length and more severe NAS signs, compared with opioid use alone, but more research is necessary to identify the minimum dosage and length of nicotine exposure to accurately predict these outcomes.

Keywords: tobacco exposure; opioid use disorder; pregnancy; neonatal abstinence syndrome; nicotine (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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