2025
Prenatal opioid exposure alters pain perception and increases long-term health risks in infants with neonatal opioid withdrawal syndrome
Radhakrishna U, Radhakrishnan R, Uppala L, Trivedi T, Prajapati J, Rawal R, Muvvala S, Bahado-Singh R, Sadhasivam S. Prenatal opioid exposure alters pain perception and increases long-term health risks in infants with neonatal opioid withdrawal syndrome. Frontiers In Pain Research 2025, 6: 1497801. PMID: 40313396, PMCID: PMC12043715, DOI: 10.3389/fpain.2025.1497801.Peer-Reviewed Original ResearchNeonatal opioid withdrawal syndromeOpioid-exposed infantsOpioid withdrawal syndromePain-related genesOpioid exposureWithdrawal syndromeChronic painEpigenetic changesMaternal opioid exposurePrenatal opioid exposureImprove pain managementIon channel functionIllumina Infinium Methylation EPIC BeadChipInfinium Methylation EPIC BeadChipAnalyzed DNA methylationUnexposed control subjectsLong-term health risksPain reliefPain perceptionPregnant womenGnRH secretionPlacental tissueMorphine addictionHealth of mothersControl subjectsMake It Happen NOW: Barriers and Inequities in Eat, Sleep, Console Implementation for Neonatal Opioid Withdrawal Syndrome.
Chaudhury N, Zhao S, Ostfeld-Johns S. Make It Happen NOW: Barriers and Inequities in Eat, Sleep, Console Implementation for Neonatal Opioid Withdrawal Syndrome. Hospital Pediatrics 2025, 15: e99-e101. PMID: 39894048, DOI: 10.1542/hpeds.2025-008332.Peer-Reviewed Original Research
2024
Comparisons of management approaches in neonatal opioid withdrawal syndrome: The eat, sleep, console approach vs. the Finnegan approach
Johnson K, Berkwitt A, Yankova L, Osborn R. Comparisons of management approaches in neonatal opioid withdrawal syndrome: The eat, sleep, console approach vs. the Finnegan approach. Seminars In Perinatology 2024, 49: 152021. PMID: 39736490, DOI: 10.1016/j.semperi.2024.152021.Peer-Reviewed Original ResearchHospital sequelae, discharge, and early interventions in infants with Neonatal Opioid Withdrawal Syndrome
Cheng F. Hospital sequelae, discharge, and early interventions in infants with Neonatal Opioid Withdrawal Syndrome. Seminars In Perinatology 2024, 49: 152008. PMID: 39581774, DOI: 10.1016/j.semperi.2024.152008.Peer-Reviewed Original ResearchNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeWithdrawal syndromeEarly interventionNeonatesSequelaeInfantsSyndromeHospital Readmissions Among Infants With Neonatal Opioid Withdrawal Syndrome
Gaither J, Drago M, Grossman M, Li Y, Shabanova V, Xu X, Leventhal J. Hospital Readmissions Among Infants With Neonatal Opioid Withdrawal Syndrome. JAMA Network Open 2024, 7: e2435074. PMID: 39316398, PMCID: PMC11423163, DOI: 10.1001/jamanetworkopen.2024.35074.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeWithdrawal syndromeCohort studyHospital readmissionLow birth weightReadmission ratesRetrospective cohort studyIncreased risk of readmissionNationwide Readmissions DatabaseClinical Modification codesGestational ageOdds of readmissionMultiple gestationsFull-termInternational Classification of DiseasesRisk of readmissionHospital discharge recordsBirth weightSurvey-weighted logistic regressionType of insuranceIncreased 5-foldIncreased riskReadmissions DatabaseYear of birthPrenatal opioid exposure significantly impacts placental protein kinase C (PKC) and drug transporters, leading to drug resistance and neonatal opioid withdrawal syndrome
Radhakrishna U, Radhakrishnan R, Uppala L, Muvvala S, Prajapati J, Rawal R, Bahado-Singh R, Sadhasivam S. Prenatal opioid exposure significantly impacts placental protein kinase C (PKC) and drug transporters, leading to drug resistance and neonatal opioid withdrawal syndrome. Frontiers In Neuroscience 2024, 18: 1442915. PMID: 39238930, PMCID: PMC11376091, DOI: 10.3389/fnins.2024.1442915.Peer-Reviewed Original ResearchNeonatal opioid withdrawal syndromeNeonatal opioid withdrawal syndrome treatmentRegulation of drug transportersOpioid use disorderOpioid withdrawal syndromeProtein kinase CDrug transportATP-binding cassetteDrug resistanceWithdrawal syndromeSevere neonatal opioid withdrawal syndromeSolute carrierPrenatal opioid exposureOpioid-exposed infantsATP-binding cassette drug transportersLevels of ATP-binding cassetteIllumina Infinium MethylationEPIC arrayKinase CMethylation changesGastric acid secretionImprove treatment outcomesDrug-drug interactionsMaternal opioidsMaternal relapseInfinium MethylationEPIC arrayPlacental cytochrome P450 methylomes in infants exposed to prenatal opioids: exploring the effects of neonatal opioid withdrawal syndrome on health horizons
Radhakrishna U, Sadhasivam S, Radhakrishnan R, Forray A, Muvvala S, Metpally R, Patel S, Rawal R, Vishweswaraiah S, Bahado-Singh R, Nath S. Placental cytochrome P450 methylomes in infants exposed to prenatal opioids: exploring the effects of neonatal opioid withdrawal syndrome on health horizons. Frontiers In Genetics 2024, 14: 1292148. PMID: 38264209, PMCID: PMC10805101, DOI: 10.3389/fgene.2023.1292148.Peer-Reviewed Original ResearchNeonatal opioid withdrawal syndromeOpioid withdrawal syndromePlacental tissueWithdrawal syndromeLong-term clinical implicationsPrenatal opioid exposureNOWS treatmentPrenatal opioidsOpioid exposureOpioid effectsOpioid usePharmacologic treatmentCYP genesControl mothersMultiple CYP genesValuable biomarkerClinical implicationsInfantsPersonalized treatmentOpioidsCytochrome P450 enzymesInfinium MethylationEPIC BeadChipTreatmentIllumina Infinium MethylationEPIC BeadChipSyndrome
2022
Midwifery Care of Pregnant Individuals Experiencing Opioid use Disorder: Changing Regulations, Complexities, and Call to Action
Bukowski H, Combellick J. Midwifery Care of Pregnant Individuals Experiencing Opioid use Disorder: Changing Regulations, Complexities, and Call to Action. Journal Of Midwifery & Women's Health 2022, 67: 770-776. PMID: 36269042, DOI: 10.1111/jmwh.13415.Peer-Reviewed Original ResearchConceptsOpioid use disorderUse disordersNeonatal opioid withdrawal syndromeCo-occurring mental disordersCo-occurring mental illnessMental Health Services AdministrationProvision of MOUDOpioid withdrawal syndromeAdministration of buprenorphineLong-term sequelaeHealth Services AdministrationDepartment of HealthMultisubstance useMedical comorbiditiesOpioid useWithdrawal syndromePractice guidelinesPregnant individualsMidwifery careMental illnessMental disordersPregnant peopleInterprofessional careSubstance abuseAddiction medicineEarly Weight Loss Percentile Curves and Feeding Practices in Opioid-Exposed Infants.
Cheng FY, Shabanova V, Berkwitt AK, Grossman MR. Early Weight Loss Percentile Curves and Feeding Practices in Opioid-Exposed Infants. Hospital Pediatrics 2022, 12: 857-866. PMID: 36073203, DOI: 10.1542/hpeds.2021-006137.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeFeeding practicesWeight loss patternsBirth weightMedian percent weight lossWeight lossMean gestational ageOpioid withdrawal syndromeMean birth weightPercentile curvesRisk of morbidityHours of lifeHealth care useConfidence intervalsOptimal feeding methodNonpharmacologic treatmentsPharmacologic treatmentWithdrawal syndromeGestational agePercent weight lossSingle centerCare useInclusion criteriaInfantsDelivery typeDelivery timing for the opioid–exposed infant
Sanusi A, Gray M, Xue Y, Mohr S, Curtis P, Dismukes J, Gentle S, Szychowski J, Brocato B, Casey B, Harper L, Sinkey R. Delivery timing for the opioid–exposed infant. American Journal Of Obstetrics & Gynecology MFM 2022, 4: 100719. PMID: 35977700, PMCID: PMC10961100, DOI: 10.1016/j.ajogmf.2022.100719.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeOpioid-exposed infantsIncidence of neonatal opioid withdrawal syndromeNeonatal opioid withdrawal syndrome treatmentLate-term periodsEarly term deliveryOpioid-exposed neonatesWithdrawal syndromePrimary composite outcomeOpioid use disorderNeonatal outcomesTerm deliveryMedication-Assisted TreatmentSyndrome treatmentComposite outcomeRisk of neonatal opioid withdrawal syndromeSeverity of neonatal opioid withdrawal syndromeNeonatal intensive care unit admissionAmerican College of Obstetricians and GynecologistsPositive urine toxicology screenPrimary outcomeSecondary outcomesNeonatal intensive care unitPositive urine drug screen
2021
Maternal opioid use disorder: Placental transcriptome analysis for neonatal opioid withdrawal syndrome
Radhakrishna U, Nath SK, Vishweswaraiah S, Uppala LV, Forray A, Muvvala SB, Mishra NK, Southekal S, Guda C, Govindamangalam H, Vargas D, Gardella WG, Crist RC, Berrettini WH, Metpally RP, Bahado-Singh RO. Maternal opioid use disorder: Placental transcriptome analysis for neonatal opioid withdrawal syndrome. Genomics 2021, 113: 3610-3617. PMID: 34352367, DOI: 10.1016/j.ygeno.2021.08.001.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeWithdrawal syndromePrenatal opioid exposureOpioid use disorderPlacentas of infantsPlacental tissue samplesP-valueIngenuity Pathway AnalysisOpioid exposureUse disordersUnexposed controlsFDR p-valueGenes CYP1A1Tissue samplesSyndromePathway analysisCYP1A1NewbornsInfantsEtiologyApoBPlacentaGenesGRIN2APlacental DNA methylation profiles in opioid-exposed pregnancies and associations with the neonatal opioid withdrawal syndrome
Radhakrishna U, Vishweswaraiah S, Uppala LV, Szymanska M, Macknis J, Kumar S, Saleem-Rasheed F, Aydas B, Forray A, Muvvala SB, Mishra NK, Guda C, Carey DJ, Metpally RP, Crist RC, Berrettini WH, Bahado-Singh RO. Placental DNA methylation profiles in opioid-exposed pregnancies and associations with the neonatal opioid withdrawal syndrome. Genomics 2021, 113: 1127-1135. PMID: 33711455, DOI: 10.1016/j.ygeno.2021.03.006.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeIngenuity Pathway AnalysisWithdrawal syndromeOpioid-exposed pregnanciesPlacental tissue samplesOpioid abusePlacental tissueTissue samplesPregnancyMethylation dysregulationGenome-wide methylation analysisSyndromeInfantsPathway analysisAUCDNA methylation profilesMethylation profilesGroupPathophysiologyTherapyStrong evidence
2020
Neonatal Opioid Withdrawal Syndrome
Patrick S, Barfield W, Poindexter B, Cummings J, Hand I, Adams-Chapman I, Aucott S, Puopolo K, Goldsmith J, Kaufman D, Martin C, Mowitz M, Gonzalez L, Camenga D, Quigley J, Ryan S, Walker-Harding L. Neonatal Opioid Withdrawal Syndrome. 2020, 146: e2020029074. PMID: 33106341, DOI: 10.1542/peds.2020-029074.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeOpioid use disorderPregnant womenMother-infant dyadsOpioid exposureWithdrawal syndromeUse disordersOpioid crisisEvidence-based therapiesVariable careClinical presentationNumber of childrenEarly interventionInfantsWomenSyndromeCareDisordersExposureMedicationsTherapyRacial association and pharmacotherapy in neonatal opioid withdrawal syndrome: thinking beyond genetics
Grossman MR, Berkwitt AK, Osborn RR. Racial association and pharmacotherapy in neonatal opioid withdrawal syndrome: thinking beyond genetics. Journal Of Perinatology 2020, 40: 689-690. PMID: 32076112, DOI: 10.1038/s41372-020-0607-3.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid withdrawal syndromeWithdrawal syndromePharmacotherapySyndromeRacial associations
2019
Opioid Use in Pregnancy
Tobon AL, Habecker E, Forray A. Opioid Use in Pregnancy. Current Psychiatry Reports 2019, 21: 118. PMID: 31734808, PMCID: PMC10296780, DOI: 10.1007/s11920-019-1110-4.Peer-Reviewed Original ResearchConceptsNeonatal opioid withdrawal syndromeOpioid use disorderOpioid exposureOpioid useMajor public health problemNeonatal adverse outcomesOpioid withdrawal syndromeStandard of carePublic health problemTerms of incidenceIllicit drug useSignificant adverse effectsMaintenance therapyPerinatal outcomesPregnancy outcomesRecent longitudinal studiesWithdrawal syndromeFetal effectsPregnant womenAdverse outcomesLong-term effectsUse disordersDrug useHealth problemsBrain morphology
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