2020 Volume 56 Issue 2 Pages 290-293
Currently, opioid use for chronic pain during pregnancy has been increasing. Opioid abuse in pregnancy is associated with neonatal abstinence syndrome（NAS）. However, there is no long-term follow-up study on the newborns.
The mother was 29 years old with a history of Gravida 2, Para 1. She used a massive dose of opioid for chronic pain that induced by fibromyalgia. She delivered her first baby without decreasing the dose of opioid （460 mg morphine equivalent per day）during pregnancy. The newborn was diagnosed as NAS with the maximum Finnegan score of 7.
Although he did not need any specific treatment for withdrawal, he was suspected of Autism Spectrum Disorders at age of 18 months. When she became pregnant with the second child, we determined to decrease the dose of her opioid. She successfully underwent reduction of opioid（up to 75 mg morphine equivalent per day）without relapse or severe pain. The newborn was also diagnosed as NAS, but the maximum Finnegan score was 4. After the delivery, she quitted all opioids and her pain is now controlled only by acetaminophen.
The use of opioid during pregnancy will possibly increase in the future. However, this case report suggests that it is important to consider appropriate dose of opioids for each patient.
