The use of therapeutic prescription narcotics in the United States has been increasing, especially in the last decade. More women of reproductive age are using prescription analgesics. Narcotic use was observed in 1 study to occur in 7.5% of all pregnancies. Although narcotic medications have not been associated with congenital malformations in human pregnancy, these medications can cause neonatal withdrawal syndrome.

Symptoms of neonatal withdrawal syndrome in the infant can appear 1-10 days after birth and include dehydration, excessive crying, diarrhea, increased muscle tone, hyperreflexia, fever, congestion, diaphoresis, irritability, difficulty sleeping, or seizures. The most severe neonatal withdrawal symptoms occur when mothers are exposed to methadone. Several investigators have reported on maternal methadone or heroin use in pregnancy and the subsequent neonatal effects. Previous reports on the incidence of neonatal withdrawal syndrome in neonates who are exposed to methadone in utero have shown a range of 11-71%. That is, of those infants who were exposed to this medication in utero, up to 71% will show signs of neonatal withdrawal syndrome. Blaser et al reported that, when methadone was used for the treatment of pain management in pregnant women, 13 of 19 infants exhibited withdrawal symptoms. The infants in this study also exhibited significant morbidity that included assisted ventilation, phototherapy for jaundice, difficulty feeding, and hypoglycemia.

There is a paucity of published information on the use prevalence of other prescription narcotics during pregnancy and the effects of this medication use on the neonate. This purpose of this study was to evaluate specifically the prevalence of chronic narcotic use in our pregnant population at the Mayo Clinic over time and to assess neonatal outcomes in these pregnancies. This study looks to provide information for the clinician, especially with regard to neonatal risks, when narcotic medication is used on a chronic basis during pregnancy.