Running Head: CURRENT TRENDS IN NARCOTIC USE
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Current Trends in Narcotic Use in Pregnancy and Neonatal Outcomes
Kellogg A, Rose CH, Harms RH etal.
American Journal of Obstetrics and Gynecology 2011; 204:259.e 1-4
Christine Miller
Penn State University
English 202A
Ms. Lori Myers
February 8, 2012
Running Head: CURRENT TRENDS IN NARCOTIC USE
Introduction
The purpose of this study was to examine the trajectory of prescription narcotic pain
medication use in pregnant women, and its effects on the infant at the time of birth. A
Retrospective study was conducted; data bases were used to examine records of women who had
given birth at the Mayo Clinic over a period of 11 years, the significance of their prescription
narcotic pain medication usage, and the effect on the infant at birth (Kellogg A, Rose CH, &
Harms RH etal. 2011).
It is mentioned throughout this article, that essentially no such exact previous research
has been done on this topic; these authors wanted to gather information on the effects of narcotic
pain medications on infants in-uetero, and subsequently after delivery, so that doctors would
understand the risks when prescribing these medications to pregnant mothers (Kellogg A, etal.).
Although this type of retrospective research on this topic had not previously been
conducted, the authors mention Wilbourne P. etal. (as cited in Kellogg A, etal.), conducted
research in 2001 at which time he found that the women he studied used narcotic pain
medication more than non-narcotic pain medication during pregnancy; 75 out of 1000.
No Hypothesis is clearly stated; the authors wanted to examine if prescription narcotic
pain medication use in pregnant women increased or decreased over a specific timeframe, and
the effects on the infant; these authors wanted to gain knowledge so that it could be shared with
doctors (Kellogg A. etal.2011). The Independent Variable in this study would be the narcotic
medications, and the dependant variable would be the effect on the neonate.
Research Methods
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Running Head: CURRENT TRENDS IN NARCOTIC USE
Retrospective Research is being conducted here; “Pregnant women who received chronic
narcotic pain medication during their pregnancy from 1998-2009 were included in the study.
Patients who used narcotic pain medication for an acute, single event (ie, surgery during the
antepartum time period) were excluded” (Kellogg A. etal. 2011). These patients all gave birth at
the Mayo Clinic throughout an 11 year span. Information was gathered from existing data bases
and clinical charts.
Results
What was discovered at the conclusion of this research study was that out of 26,314
births, 177 babies born were born to mothers who consumed prescribed narcotic medication
throughout their pregnancy. Additionally, the number of pregnant women consuming narcotic
medications increased over the 11 year period examined (Kellogg, A. etal.2011). Regarding the
effects on the neonates, “Most of these infants were admitted to the neonatal intensive care unit
for prematurity and its associated complications. Ten of the 177 infants (5.6%) were diagnosed
with neonatal withdrawal syndrome: all but 1 of these neonates required pharmacologic
treatment” (Kellogg, A. etal 2011).
What the authors seem to believe is significant with regard to this topic is that much
information is published on the aftermath of prescription narcotics on the infants, and much less
appears to have been published in order to inform individuals before it occurs. This is what
prompted these authors to conduct this type of research; they wanted to take a look back to see if
these behaviors had increased over time and what the effects were on the infants. The hope is
that doctors will weigh the good and the bad and make more informed decisions with regard to
prescribing narcotic medications to pregnant women (Kellogg, A. etal. 2011).
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Running Head: CURRENT TRENDS IN NARCOTIC USE
Discussion
One limitation to this study was that it could not be guaranteed that the women took the
medication, only that it was prescribed; the amount of medication taken is important, as it relates
to the withdrawal of the infant (Kellogg, A. etal). In addition, the authors did not consider if
these women smoked cigarettes, or took in any other chemicals throughout their pregnancies.
With regard to future studies, the authors felt that, “Further prospective research on prescription
narcotic use during pregnancy may better define the effects of drug quantity, duration, timing of
use during pregnancy, and maternal comorbidities on neonatal outcomes” (Kellogg, A. etal.
2011).
Comments
I feel that this research is helpful in examining the effects of narcotics on infants in utero,
however; there is a much more significant issue here. Although this study indicates that the
women taking these narcotics during pregnancy were taking them for legitimate reasons, we
cannot be absolutely sure that this is true. This may seem a bit harsh, however; I see individuals
on a daily basis who are addicted to narcotic medications and have received these medications
from doctors very easily, and under false pretenses. I feel that it is extremely important for
doctors to understand addiction, and the horrific consequences that result in misuse of narcotics.
This issue becomes even more significant when a woman is pregnant. It is clear to me after
having conversations with medical professionals that training in the area of addiction is lacking
in medical training. It is my opinion that more time and effort should be focused on educating
doctors on the disease of addiction so that babies do not have to come into this world addicted.
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Running Head: CURRENT TRENDS IN NARCOTIC USE
A better study design might include a longitudinal study of addicts from the onset of
addiction. Instead of looking at what has already occurred, a better route may be to follow
addicts when the addiction is initially arrested, and delve into the psyche. Try to understand the
addicts frame of mind; there struggles, triumphs and tragedies. Maybe if an understanding and
knowledge are gained, doctors may examine clients more thoroughly and refrain from
prescribing narcotics so haphazardly. Instead of conducting retrospective research, I believe
addicts should be observed in the here and now to avoid tragedy in the future.
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Running Head: CURRENT TRENDS IN NARCOTIC USE
References
Kellogg A, Rose CH, Harms RH, et al. Current Trends in Narcotic use in Pregnancy and
Neonatal Outcomes. AM J Obstet Gynecol 2011;204:259.e1-4
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