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Review
. 2024 Feb 23;11(3):278.
doi: 10.3390/children11030278.

Fetal and Infant Effects of Maternal Opioid Use during Pregnancy: A Literature Review including Clinical, Toxicological, Pharmacogenomic, and Epigenetic Aspects for Forensic Evaluation

Elena Giovannini  1 , Maria Paola Bonasoni  1   2 , Jennifer Paola Pascali  1 , Carla Bini  1 , Guido Pelletti  1 , Alberto Gualandi  3 , Giovanni Dal Lago  1 , Andrea Mercati  1 , Beatrice Mariotti  1 , Giulia Paola Pasini  1 , Iarina Alexandra Poll  1 , Paolo Fais  1
Affiliations
Review

Fetal and Infant Effects of Maternal Opioid Use during Pregnancy: A Literature Review including Clinical, Toxicological, Pharmacogenomic, and Epigenetic Aspects for Forensic Evaluation

Elena Giovannini et al. Children (Basel). .

Abstract

The two primary classes of opioid substances are morphine and its synthetic derivative, heroin. Opioids can cross the placental barrier, reaching fetal circulation. Therefore, at any gestational age, the fetus is highly exposed to pharmacologically active opioid metabolites and their associated adverse effects. This review aimed to investigate all the studies reported in a timeframe of forty years about prenatal and postnatal outcomes of opioid exposition during pregnancy. Clinical and toxicological aspects, as well as pharmacogenetic and epigenetic research focusing on fetal and infant effects of opioid use during pregnancy together with their medico-legal implications are exposed and discussed.

Keywords: buprenorphine; epigenetic; methadone; neonatal withdrawal symptoms from opioid drugs (NOWS); opioids in pregnancy; pharmacogenomic; toxicology.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of the systematic review.
Figure 2
Figure 2
Studies organized by issue of interest. Foetus and infant clinical complications: Borrelli et al. 2022 [20], O’Donnell et al.2017 [22], Wolff et al. 2014 [24], Maguire et al. 2020 [26], Benck et al. 2023 [27], Caritis et al. 2019 [29], Conradt et al. 2019 [31], Dryden et al. 2022 [34], Duska et al. 2022 [35], Epstein et al.2013 [36], Galli et al. 2023 [37], Garrison et al.2016 [38], Irnes et al. 2017 [39], Kushnir et al. 2023 [42], McCarthy et al. 2023 [43], McGlone et al. 2014 [45], Monnelly et al. 2019 [46], Newbury et al. 2023 [49], Ramirez et al. 2006 [54], Spowart et al. 2023 [58], Towers et al.2019 [60]. Foetus and infant cause of death: Kaltenbach et al. 1998 [1], Sithisarn et al. 2012 [2], Friguls et al. 2012 [6], Lam et al. 1992 [9], Fishman et al. 2019 [11], Rausgaard et al. 2023 [14], Bashore et al. 1981 [16], Anbalagan et al. 2023 [17], Ryan et al. 2023 [18], Esposito et al. 2022 [19], Little et al. 1990 [21], Kandall et al. 1976 [23], Athanasakis et al 2011 [25], Burns et al.2010 [28], Cohen et al. 2015 [30], Kandall et al. 1991 [40], Kandall et al. 1993 [41], Montanari et al. 2018 [47], Montanari et al. 2019 [48], Serra et al. 2017 [57], Ward et al. 1990 [59], Whiteman et al. 2014 [61], Wurst et al. 2016 [63]. Genetic analyses: Borrelli et al. 2022 [20], Crews et al. 2021 [66], CPIC Guideline 2022 [67], Yalçin et al. 2022 [68], Madadi et al. 2012 [69], Mactier et al.2012 [70], McPhail et al. 2021 [71], Liu et al. 2016 [72], van Hoogdalem et al. 2021 [73], Wachman et al. 2013 [74], Koren et al. 2006 [77], Madadi et al. 2009 [78], Friedrichsdorf et al. 2013 [79], Madadi et al. 2007 [80], Sistonen et al. 2012 [81], Claessens et al. 2010 [82], Badaoui et al. 2021 [83], Pogliani et al. 2012 [84], Elens et al. 2016 [85], Matic et al. 2014 [86], Hronová et al. 2016 [87], Matic et al. 2014 [88], Matic et al. 2016 [89], Baldo et al. 2023 [90], Dennis et al. 2014 [91], Wachman et al. 2014 [92], Wachman al. 2018 [93]. Toxicological analyses: Bertaso et al. 2023 [5], Pötsch et al. 1999 [12], Bhatt-Mehta et al. 2023 [15], Concheiro et al. 2017 [32], de Castro et al.2011 [33], López et al. 2009 [44], Pandya et al. 2023 [50], Ordean et al. 2023 [51], Ostrea et al. 2001 [52], Parikh et al. 2011 [53], Robert et al. 2007 [55], Ross et al.2015 [56], Walhovd et al. 2010 [62], Zedler et al. 2016 [64], Zipursky et al. 2021 [65], Albano et al. 2023 [75], Kintz et al. 2015 [76].
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