NAS occurs when a pregnant women takes opioid drugs during pregnancy, and the baby is born dependent on them. Drugs like prescription painkillers and the illegal drug heroin are opioid drugs that pass through the placenta to the unborn baby.
NAS begins within a few days after the baby is born. It can cause respiratory distress, seizures, fever, diarrhea, restlessness, and trouble feeding. These babies may be born with low birth weights and be difficult to soothe. Babies who suffer from NAS may have to remain in the hospital for an average of 15 days, NBC News reports, increasing the hospital-related expenses to five times those of what non-NAS babies will incur after birth.
Is Suboxone Used during Pregnancy?Suboxone is a drug that is approved by the U.S. Food and Drug Administration (FDA) for the treatment of opioid dependency. Suboxone contains a partial opioid agonist, buprenorphine, combined with an opioid antagonist naloxone. This drug is prescribed to help wean individuals off faster-acting and full agonist opioids like heroin, OxyContin, or hydrocodone products. Opioid withdrawal can be intense, causing flulike physical symptoms and difficult emotional symptoms, such as depression, irritability, and anxiety.
Opioid withdrawal can be especially harmful to an unborn baby, potentially resulting in preterm labor, fetal distress, or even miscarriage.
For this reason, it is recommended that pregnant women do not stop taking an opioid drug suddenly during pregnancy if they are dependent on it. Instead, a drug like methadone or a buprenorphine product may be helpful, especially when introduced in the second trimester, to decrease the risks of opioid withdrawal and danger to the fetus, the American College of Obstetricians and Gynecologists (ACOG) publishes.
Buprenorphine may still result in NAS, although symptoms are thought to be shorter lasting and less severe, starting in the first 12-48 hours after birth, peaking in 72-96 hours, and lasting about a week, according to ACOG. Naloxone, the second component in Suboxone, is thought to be dangerous to an unborn baby, however, potentially causing hormonal changes in both the fetus and the mother, the journal Contemporary OB/GYN reports. The naloxone part of Suboxone can precipitate opioid withdrawal when abused, making it very risky to both the mother and the fetus during pregnancy. There is a relative lack of data on the safety of this opioid antagonist when used during pregnancy.
Therefore, when buprenorphine is used during pregnancy to prevent opioid withdrawal, it is usually in single-action formulations and not combination products like Suboxone.
Opioids and Possible Birth Defects
Other potential side effects of taking an opioid, or an opioid-containing drug such as Suboxone, during pregnancy may include the potential for babies to be born with several different birth defects. The Centers for Disease Control and Prevention (CDC) lists the following as potential birth defects that can occur when pregnant mothers take opioid analgesics during pregnancy:
- Hydrocephaly: an excessive buildup of spinal fluid in the brain that can cause babies to be born with extra-large heads and dangerous amounts of pressure on the brain
- Glaucoma: a condition affecting the eye that can cause damage to the optic nerve and may result in blindness
- Congenital heart defects: abnormalities in the formation and structure of the heart that can lead to a number of different defects and heart problems
- Spina bifida: a neural tube defect caused when the baby’s spinal cord doesn’t develop properly and can cause both cognitive and physical disabilities, depending on the severity
- Gastroschisis: a hole in the abdominal wall that can make the baby’s intestines stick out, sometimes even outside the body through a hole in the belly button