Identifying Co-Exposure to Opiates and Gabapentin During Pregnancy

Loudin, Sean; Haas, Jessica; Payne, Mary; Linz, Marianna Footo; Meaney‐Delman, Dana; Honein, Margaret A.; Saunders, Amy

doi:10.1016/j.jpeds.2019.09.029

Cited by 6 publications

(3 citation statements)

References 8 publications

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“…Previous studies on the use of antiepileptics during pregnancy have concluded that valproic acid, lamotrigine, and carbamazepine are associated with smaller head circumference observed in the fetus ( Margulis et al, 2019 ). Moreover, another study showed that gabapentin administration during pregnancy is associated with adverse gestational outcomes ( Loudin et al, 2020 ). Therefore, the safety of the usage of gabapentin during pregnancy has not yet been conclusively determined ( Loudin et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, another study showed that gabapentin administration during pregnancy is associated with adverse gestational outcomes ( Loudin et al, 2020 ). Therefore, the safety of the usage of gabapentin during pregnancy has not yet been conclusively determined ( Loudin et al, 2020 ). Thus, antiepileptics, such as gabapentin are generally prescribed according to the risk-to-benefit ratio ( Guttuso et al, 2014 ; Patorno et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

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Prenatal Exposure to Gabapentin Alters the Development of Ventral Midbrain Dopaminergic Neurons

et al. 2022

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Background: Gabapentin is widely prescribed as an off-label drug for the treatment of various diseases, including drug and alcohol addiction. Approximately 83–95% of the usage of gabapentin is off-label, accounting for more than 90% of its sales in the market, which indicates an alarming situation of drug abuse. Such misuse of gabapentin has serious negative consequences. The safety of the use of gabapentin in pregnant women has always been a serious issue, as gabapentin can cross placental barriers. The impact of gabapentin on brain development in the fetus is not sufficiently investigated, which poses difficulties in clinical decisions regarding prescriptions.Methods: The consequences effect of prenatal gabapentin exposure on the development of ventral midbrain dopaminergic neurons were investigated using three-dimensional neuronal cell cultures. Time-mated Swiss mice were used to isolate embryos. The ventral third of the midbrain was removed and used to enrich the dopaminergic population in 3D cell cultures that were subsequently exposed to gabapentin. The effects of gabapentin on the viability, ATP release, morphogenesis and genes expression of ventral midbrain dopaminergic neurons were investigated.Results: Gabapentin treatment at the therapeutic level interfered with the neurogenesis and morphogenesis of vmDA neurons in the fetal brain by causing changes in morphology and alterations in the expression of key developmental genes, such as Nurr1, Chl1, En1, Bdnf, Drd2, and Pitx3. The TH + total neurite length and dominant neurite length were significantly altered. We also found that gabapentin could halt the metabolic state of these neuronal cells by blocking the generation of ATP.Conclusion: Our findings clearly indicate that gabapentin hampers the morphogenesis and development of dopaminergic neurons. This implies that the use of gabapentin could lead to serious complications in child-bearing women. Therefore, caution must be exercised in clinical decisions regarding the prescription of gabapentin in pregnant women.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prenatal Exposure to Gabapentin Alters the Development of Ventral Midbrain Dopaminergic Neurons

et al. 2022

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“…Women with OUD experience other mental health issues and the need for psychotropic medications ( 13 , 14 ). Infants exposed to maternal opioids were more likely to require pharmacotherapy when co-exposed to benzodiazepines ( 15 ), tobacco ( 16 ), selective serotonin reuptake inhibitors ( 16 – 18 ), gabapentin ( 19 ), marijuana ( 20 ), or cocaine ( 21 ). The use of psychotropic medications in addition to prescription opioids increased the severity of NAS by two-fold compared to the use of prescription opioids alone ( 22 ).…”

Section: Effects Of Polysubstance Use On the Severity Of Nasmentioning

confidence: 99%

The immediate and long-term effects of prenatal opioid exposure

Yen

Davis

2022

Front. Pediatr.

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The opioid epidemic has adversely affected neonates and children, yet the mechanisms by which it impacts this population are not well understood. Not only does prenatal opioid exposure result in short-term consequences shortly after birth, it also creates long-term sequelae that may predispose these children to physical, emotional, psychiatric, cognitive, and socioeconomic problems in the future. This article provides a scoping overview of the long-term effects of antenatal opioid exposure on neonates and children as well as quality improvement and research efforts to understand and mitigate this major public health concern.

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