Effects of Drug Exposure on the Health of Women and Children

A special issue of Pathophysiology (ISSN 1873-149X).

Deadline for manuscript submissions: closed (15 July 2024) | Viewed by 9448

Special Issue Editors


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Guest Editor
Department of Emergency Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA
Interests: trends in drug abuse; opioid-induced neuronal degeneration; women and children health

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Guest Editor
Department of Computer Science, Louisiana State University Shreveport, Shreveport, LA, USA
Interests: data analytics; visualization; bioinformatics

Special Issue Information

Dear Colleagues,

We would like to invite you to contribute to a Special Issue of Pathophysiology entitled “Effects of Drug Exposure on the Health of Women and Children”. There is a growing health crisis among women and children due to exposure to prescription drugs and illegal substances. Women experience unique issues while dealing with drug abuse that are associated with their biology and socioeconomic and sociocultural issues. Recent studies indicate that women develop an addiction to drugs more quickly, use lower doses when compared to men, experience more severe signs of withdrawal, and are more likely to relapse. The dangers of multi-substance misuse include an increased risk of overdose, impaired physical and mental functions, a decline in quality of life, and mortality due to overdose or suicidal ideation. During pregnancy, most substances may be transferred through the placenta to the fetus, which could result in the development of Neonatal Abstinence Syndrome (NAS) in a newborn and affect child development. Moreover, involuntary drug exposure during childhood may contribute to psychiatric and behavioral symptoms in the child and affect cognitive functions and language.

This Special Issue is dedicated to identifying and addressing problems associated with drug exposure in women and children that affect their mental and physical health as well the consequences of prenatal and perinatal drug exposure on child development. We welcome reviews, original studies, and case reports that improve our understanding of these effects and how to mitigate them.

We look forward to your contributions.

Dr. Nadejda Korneeva
Prof. Dr. Urska Cvek
Guest Editors

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Keywords

  • substance abuse
  • opiates and opioids 
  • benzodiazepine
  • cannabinoids, marijuana 
  • methamphetamine and amphetamines 
  • prescription drugs 
  • neonatal abstinence syndrome 
  • child development 
  • female 
  • addiction 
  • stress

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Published Papers (3 papers)

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Research

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14 pages, 3229 KiB  
Article
Trends in Drug Tests among Children: A 22-Year Retrospective Analysis
by Carolina Ochoa, Phillip C. S. R. Kilgore, Nadejda Korneeva, Eric Clifford, Steven A. Conrad, Marjan Trutschl, Jacquelyn M. Bowers, Thomas Arnold and Urska Cvek
Pathophysiology 2023, 30(2), 219-232; https://doi.org/10.3390/pathophysiology30020019 - 12 May 2023
Cited by 2 | Viewed by 1910
Abstract
There are several pathophysiological outcomes associated with substance abuse including metabolic disbalance, neurodegeneration, and disordered redox. Drug use in pregnant women is a topic of great concern due to developmental harm which may occur during gestation and the associated complications in the neonate [...] Read more.
There are several pathophysiological outcomes associated with substance abuse including metabolic disbalance, neurodegeneration, and disordered redox. Drug use in pregnant women is a topic of great concern due to developmental harm which may occur during gestation and the associated complications in the neonate after delivery. We sought to determine what the trajectory of drug use is like in children aged 0–4 years and mothers of neonates. Urine drug screen (UDS) results were obtained of our target demographic during 1998–2011 and 2012–2019 from LSU Health Sciences Center in Shreveport (LSUHSC-S). Statistical analysis was performed using R software. We observed an increase in cannabinoid-positive UDS results in both Caucasian (CC) and African American (AA) groups between 1998–2011 and 2012–2019 periods. Cocaine-positive UDS results decreased in both cohorts. CC children had higher UDS positive results for opiates, benzodiazepines, and amphetamines, while AA children had a higher percentage for illicit drugs such as cannabinoids and cocaine. Neonate’s mothers had similar UDS trends to that in children during 2012–2019. Overall, while percentage of positive UDS results for both AA and CC 0–4 year old children started to decline for opiate, benzodiazepine, and cocaine during 2012–2019, cannabinoid- and amphetamine (CC)-positive UDS steadily increased. These results suggest a shift in the type of drug use by mothers from opiates, benzodiazepines, and cocaine to cannabinoids and/or amphetamines. We also observed that 18-year-old females who tested positive for opiates, benzodiazepine, or cocaine had higher than average chances of testing positive for cannabinoids later in life. Full article
(This article belongs to the Special Issue Effects of Drug Exposure on the Health of Women and Children)
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Review

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12 pages, 271 KiB  
Review
Acromegaly: Pathophysiological Considerations and Treatment Options Including the Evolving Role of Oral Somatostatin Analogs
by Charles P. Daniel, Maxwell J. Wagner, Grant E. Borne, Connor J. Plaisance, Shahab Ahmadzadeh, Alfonso Aquino, Sahar Shekoohi, Adam M. Kaye, Elyse M. Cornett and Alan D. Kaye
Pathophysiology 2023, 30(3), 377-388; https://doi.org/10.3390/pathophysiology30030029 - 1 Sep 2023
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Abstract
Acromegaly is a condition most commonly diagnosed in the fifth decade of life and has numerous treatment options. In this regard, Mycapssa® is the first FDA-approved oral octreotide capsule for treating acromegaly, combining the efficacy of the somatostatin receptor ligand, octreotide, with [...] Read more.
Acromegaly is a condition most commonly diagnosed in the fifth decade of life and has numerous treatment options. In this regard, Mycapssa® is the first FDA-approved oral octreotide capsule for treating acromegaly, combining the efficacy of the somatostatin receptor ligand, octreotide, with the ease of a twice-daily oral capsule. Where surgical treatment is not an option, somatostatin analogs, including octreotide, are the first line of medical treatment for acromegaly, requiring regular subcutaneous or intramuscular injections administered by a patient’s healthcare provider. Octreotide capsules (Mycapssa®) provide an alternative to these somatostatin receptor ligand injections by combining octreotide with other excipients to produce a transient permeability enhancer technology that improves paracellular transport of octreotide across the gastrointestinal wall into the small intestine. Across multiple trials, including open-label (CH-ACM-01), double-blind placebo-controlled (CHIASMA OPTIMAL), and open-label extension of the trial period (CHIASMA OPTIMAL OLE), Mycapssa® octreotide capsules maintained a consistent biochemical normalization of IGF-1 and GH levels, safety profiles similar to injected somatostatin receptor ligands, and patient preference to continued treatment with octreotide capsules. While clinical trial data supports the use of octreotide capsules (Mycapssa®) in the pharmacological management of GH and IGF-1 levels, very little data exist regarding the drug’s efficacy, tolerability, and use in female or pediatric-specific populations. A better understanding of the efficacy, application, and role of oral octreotide capsules in the long-term medical management of acromegaly in a diversity of populations is imperative to best determine the risks/benefits for the clinician. Full article
(This article belongs to the Special Issue Effects of Drug Exposure on the Health of Women and Children)

Other

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10 pages, 555 KiB  
Systematic Review
Safety and Efficacy of Buprenorphine-Naloxone in Pregnancy: A Systematic Review of the Literature
by Alice Ordean and Meara Tubman-Broeren
Pathophysiology 2023, 30(1), 27-36; https://doi.org/10.3390/pathophysiology30010004 - 11 Feb 2023
Cited by 9 | Viewed by 3390
Abstract
The prevalence of opioid use among pregnant people has been increasing over the past few decades, with a parallel increase in the rate of neonatal abstinence syndrome. Opioid agonist treatment (OAT) including methadone and buprenorphine is the recommended management method for opioid use [...] Read more.
The prevalence of opioid use among pregnant people has been increasing over the past few decades, with a parallel increase in the rate of neonatal abstinence syndrome. Opioid agonist treatment (OAT) including methadone and buprenorphine is the recommended management method for opioid use disorders during pregnancy. Methadone has been extensively studied during pregnancy; however, buprenorphine was introduced in the early 2000s with limited data on the use of different preparations during pregnancy. Buprenorphine-naloxone has been incorporated into routine practice; however, only a few studies have investigated the use of this medication during pregnancy. To determine the safety and efficacy of this medication, we conducted a systematic review of maternal and neonatal outcomes among buprenorphine-naloxone-exposed pregnancies. The primary outcomes of interest were birth parameters, congenital anomalies, and severity of neonatal abstinence syndrome. Secondary maternal outcomes included the OAT dose and substance use at delivery. Seven studies met the inclusion criteria. Buprenorphine-naloxone doses ranged between 8 and 20 mg, and there was an associated reduction of opioid use during pregnancy. There were no significant differences in gestational age at delivery, birth parameters, or prevalence of congenital anomalies between buprenorphine-naloxone-exposed neonates and those exposed to methadone, buprenorphine monotherapy, illicit opioids, or no opioids. In studies comparing buprenorphine-naloxone to methadone, there were reduced rates of neonatal abstinence syndrome requiring pharmacotherapy. These studies demonstrate that buprenorphine-naloxone is a safe and effective opioid agonist treatment for pregnant people with OUD. Further large-scale, prospective data collection is required to confirm these findings. Patients and clinicians may be reassured about the use of buprenorphine-naloxone during pregnancy. Full article
(This article belongs to the Special Issue Effects of Drug Exposure on the Health of Women and Children)
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