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Naloxone for opiate-exposed newborn infantsMcGuire W, Fowlie PW
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SummaryNaloxone for opiate-exposed newborn infantsWhen a pregnant woman uses opiates (for example, morphine and similar drugs) for pain relief in labour her newborn baby's breathing may be depressed. Naloxone, a drug that counters the effects of opiates, is often used to help resuscitate such newborns. This review did not find any evidence that naloxone reduces the need for assisted breathing or admission to neonatal care units for babies born after women used opiate-based pain relief in labour. More research is needed on the effects of naloxone on babies when the mother has been using opiates during pregnancy.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2008 Issue 3, Copyright © 2008 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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October 21. 2002 AbstractBackgroundNaloxone, a specific opiate antagonist, is available for the management of newborn infants with respiratory depression that may be due to intrauterine exposure to opiate. However, it is unclear which groups of newborn infants may benefit from this therapy, and whether naloxone has any harmful effects. ObjectivesTo determine the effect of naloxone on the need for or duration of ventilatory support or neonatal unit admission in newborn infants who have been exposed in-utero to narcotics. Search strategyThe standard search strategy of the Cochrane Neonatal Review Group was used. This included electronic searches of the Cochrane Controlled Trials Register (The Cochrane Library, Issue 1, 2007), MEDLINE (1966 - February 2007), EMBASE (1988 - February 2007), and previous reviews including cross references. Selection criteriaRandomised controlled trials comparing the administration of naloxone versus placebo, or no drug, or another dose of naloxone, to newborn infants with suspected or confirmed in-utero exposure to narcotics. Data collection and analysisData were extracted using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by each author and synthesis of data using relative risk, risk difference and weighted mean difference. Main resultsNine trials that compared the effects of naloxone versus placebo or no drug in newborn infants exposed to maternal opiate analgesia prior to delivery were identified. None of these trials specifically recruited infants with respiratory depression. The main outcomes reported were measures of respiratory function in the first six hours of life. There is some evidence that naloxone increases alveolar ventilation. However, no data on the pre-specified primary outcomes of this review were noted (the need for assisted mechanical ventilation or admission to a neonatal unit). Authors' conclusionsThere is a need for a randomised controlled trial to determine if naloxone confers any clinically important benefits to newborn infants with respiratory depression that may be due to intrauterine exposure to opiate. |
