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STUDY: Surgery before pregnancy leads to increased risk of opioid withdrawal in babies


In a study, it has been found that babies whose mothers underwent surgery before pregnancy have an increased risk of opioid withdrawal symptoms at birth.

The study was published in the journal, 'Canadian Medical Association Journal'

Dr Nathalie Auger, lead author of the study said: "Use of opioids for pain control after surgery may increase the risk of opioid dependence in women and withdrawal in their newborns."

"We found mothers who had surgery before pregnancy had 1.6 times the risk of neonatal abstinence syndrome; that is, opioid withdrawal symptoms in their future newborns, perhaps because opioid use continues after surgery," Auger added.

The study included data on almost 2.2 million births in Quebec between 1989 and 2016. Of the total, 2346 newborns had neonatal abstinence syndrome and, of these, 1052 had mothers who underwent pre-pregnancy surgery (14.9 per 10 000 babies) compared with 1294 babies (8.8 per 10 000) born to mothers who did not have surgery.

Multiple surgeries; younger age at surgery; the longer time between surgery and pregnancy; and cardiovascular, thoracic, urologic, or neurosurgery were associated with the largest risk of neonatal abstinence syndrome. There was also a strong association with general anaesthesia, perhaps because this type of anaesthesia is used in more complex surgeries, which can require longer use and higher dosage of pain relievers.

"Physicians have the potential to prevent neonatal abstinence syndrome with careful postoperative pain management in young women," said Dr Auger.

"Opioids continue to be overprescribed, despite calls to optimize postsurgical pain control through improvement of surgical guidelines and use of multipronged approaches with non-opioid painkillers or local anaesthesia," she concluded. 

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