Anesthesia of a drug-addicted pregnant woman. The current state of knowledge
More details
Hide details
Department of Anesthesiology and Intensive Care, Regional Specialist Hospital in Olsztyn, Poland
Department of Anaesthesiology and Intensive Care, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
Intensive Care and Anesthesiology Department, Independent Public Healthcare Complex in Przasnysz, Poland
Clinical Gynecology and Obstetrics Department, Regional Specialist Hospital in Olsztyn, Poland
Department of Obstetrics, School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Poland
Submission date: 2023-07-14
Final revision date: 2023-12-19
Acceptance date: 2023-12-19
Online publication date: 2024-02-27
Corresponding author
Damian Bronisław Truszczyński   

Walentego Barczewskiego 1/42, 10-061 Olsztyn, Poland
Pol. Ann. Med. 2024;31(1):63-68
Stimulant use during pregnancy is a growing concern, particularly in the USA and Europe. This article explores anesthesia challenges in pregnant patients with substance abuse, optimizing analgesic treatment, and addressing newborns of addicted mothers. Understanding substance use differences is crucial for managing complications and providing long-term care.

Investigate anesthesia management, analgesic optimization, and care for newborns of drug-addicted pregnant patients.

Material and methods:
A comprehensive literature review included articles from PubMed (from January 2009 to December 2021) and relevant Polish, English, and German literature.

Results and discussion:
Opioid use by pregnant women, especially in North America, raises concerns for maternal and child health. The incidence of newborns with withdrawal syndrome is rapidly increasing. Anesthesia challenges arise in managing pregnant patients with addiction, including analgesia optimization and reducing neonatal abstinence syndrome risk. Individualized approaches like regional anesthesia minimize systemic opioids and neonatal withdrawal symptoms. Medication-assisted therapy, e.g., buprenorphine and methadone, reduces illicit opioid use and improves outcomes for mother and baby. Collaborative care among providers is essential.

Managing drug-addicted pregnant women requires a multidisciplinary approach. Anesthesia providers play a crucial role in ensuring safety and pain control.

None declared.
None declared.
Smid MC, Metz TD, Gordon AJ. Stimulant use in pregnancy: An under-recognized epidemic among pregnant women. Clin Obstet Gynecol. 2019;62(1):168–184.
Desai RJ, Hernandez-Diaz S, Bateman BT, Huybrechts KF. Increase in prescription opioid use during pregnancy among Medicaid-enrolled women. Obstet Gynecol. 2014;123(5):997–1002.
Patrick SW, Dudley J, Martin PR, et al. The prescription opioid epidemic and infant outcomes. Pediatrics. 2015;135(5):842–850.
Zhao JP, Berthod C, Sheehy O, Kassaï B, Gorgui J, Bérard A. Prevalence and duration of prescribed opioid use during pregnancy: a cohort study from the Quebec Pregnancy Cohort. BMC Pregnancy Childbirth. 2021;21(1):800.
Huybrechts KF, Bateman BT, Desai RJ, et al. Risk of neonatal drug withdrawal after intrauterine co-exposure to opioids and psychotropic medications: cohort study. BMJ. 2017;358:j3326.
Długaszek M. Problem of Opioid Use by Pregnant Women [in Polish]. Accessed: 2024.02.01.
O'Brien BP, Murphy D, et al. The functional outcome and recovery of patients admitted to an intensive care unit following drug overdose: a follow-up study. Anaesth Int Care. 2009;37(5):802–806.
Broussard CS, Rasmussen SA, Reefhuis J, et al.; National Birth Defects Prevention Study. Maternal treatment with opioid analgesics and risk for birth defects. Am J Obstet Gynecol. 2011;204(4):314.e1–11.
Jones HE, Deppen K, Hudak ML, et al. Clinical care for opioid-using pregnant and postpartum women: the role of obstetric providers. Am J Obstet Gynecol. 2014;210(4):302–310.
Faitot V, Simonpoli A, Keita B. Anaesthetic and analgesic considerations in drug-abusing pregnant women [in French]. Ann Fr Anesth Reanim. 2009;28(6):609–614.
Gerbershagen HJ, Aduckathil S, van Wijck AJM. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013;118(4):934–944.
Davies JM, Posner KL, Lee LA, Cheney FW, Domino KB. Liability associated with obstetric anesthesia: A closed claims analysis. Anesthesiology. 2009;110(1):131–139.
Hetea A, Cosconel C, Stanescu AAM, Simionescu AA. Alcohol and psychoactive drugs in pregnancy. Maedica (Bucur). 2019;14(4):397–401.
Minozzi S, Amato L, Jahanfar S, Bellisario C, Ferri M, Davoli M. Maintenance agonist treatments for opiate-dependent pregnant women. Cochrane Database Syst Rev. 2020;11:CD006318.
Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ. Saving Lives, Improving Mothers’ Care: Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2014–2016. Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2020.
Journals System - logo
Scroll to top