June 28, 2018 | A biomagnetic technique developed at the University of Arkansas for Medical Sciences (UAMS) can be used to assess the brain and heart health of third-trimester fetuses exposed to opioids, UAMS researchers showed in a recent pilot study.
The study was published online this month in the medical journal Addiction, authored by Diana Escalona-Vargas, Ph.D., research faculty in the Department of Obstetrics and Gynecology; and Jessica Coker, M.D., assistant professor in the Department of Psychiatry and the Department of Obstetrics and Gynecology, all in the College of Medicine.
The study was conducted by recording and analyzing biomagnetic data from fetuses of eight women exposed to the opioid buprenorphine and 16 non-exposed women. Researchers acquired the data noninvasively by using the SARA (SQUID-Array for Reproductive Assessment) device developed by UAMS researchers.
During the SARA examination, the pregnant woman sits against a concave shield that covers her abdomen. More than 100 sensors obtain three-dimensional data from the fetus and the uterus – without employing needles or any other invasive instruments. Advanced techniques with the SARA allowed for the simultaneous examination of cardiac and brain activities in the fetuses.
Exposure of fetuses to opioids, including buprenorphine, has been shown to affect fetal activity, specifically heart rate variability and fetal movement. Opioid-dependent pregnant women are treated with the opioids buprenorphine or methadone because those drugs are thought to have less effect on the fetus than other opioids and keep the women from going through the cycle of detoxification then relapse.
Babies born after exposure to opioids in the womb are immediately at risk for withdrawal, which can include tremors, seizures, excessive crying, breathing problems and more.
Current standards of care include the use of opioid maintenance therapy during pregnancy instead of detoxification because of the high rates of relapse and potential adverse effects on the fetus. Little is known about any risks to the fetus from intoxication or detoxification from opioids. Understanding how buprenorphine or opioids may impact the development of the fetus is also important for health care providers
“A biomagnetic device such as SARA could help to understand the impact of buprenorphine on the clinical care of pregnant women with opioid use disorder as well as care of their exposed children,” Escalona-Vargas said.
“The use of opioid maintenance therapy has grown along with the opioid epidemic in the United States,” Coker said. “For pregnant women, studies like these can help us identify babies who may be at higher risk for negative outcomes such as neonatal abstinence syndrome.”
According to the National Institute on Drug Abuse, the incidence of neonatal opioid withdrawal syndrome has increased about 400 percent nationally, from 1.2 per 1,000 hospital births in 2000 to 5.8 per 1,000 in 2012, with some states reporting rates in excess of 30 per 1,000 hospital births.
Researchers and co-authors in the study are Shona Ray-Griffith, M.D., assistant professor in the UAMS Department of Psychiatry; Eric R. Siegel, research associate in the UAMS College of Medicine Department of Biostatistics; Curtis Lowery, M.D., chair of the UAMS Department of Obstetrics and Gynecology; Zachary Stowe, M.D., Department of Psychiatry, University of Wisconsin School of Medicine and Public Health in Madison, Wisconsin; and Hari Eswaran, Ph.D., professor in the UAMS Department of Obstetrics and Gynecology.