Institute of Experimental Medicine, Hungarian Academy of Sciences, Budapest, Hungary; János Szentágothai School of Neurosciences, Semmelweis University, Budapest, Hungary.
Department of Pharmacology and Pharmacotherapy, Semmelweis University, Budapest, Hungary.
Life Sci. 2014 May 28;104(1-2):1-8. doi: 10.1016/j.lfs.2014.04.006. Epub 2014 Apr 15.
Opioids are among the world's oldest known drugs used mostly for pain relief, but recreational use is also widespread. A particularly important problem is opioid exposure in females, as their offspring can also be affected. Adverse intrauterine and postnatal environments can affect offspring development and may lead to various disabilities later in life. It is clear that repetitive painful experiences, such as randomly occurring invasive procedures during neonatal intensive care, can permanently alter neuronal and synaptic organization and therefore later behavior. At the same time, analgesic drugs can also be harmful, inducing neuronal apoptosis or withdrawal symptoms in the neonate and behavioral alterations in adulthood. Hence, risk-benefit ratios should be taken into consideration when pain relief is required during pregnancy or in neonates. Recreational use of opioids can also alter many aspects of life. Intrauterine opioid exposure has many toxic effects, inducing poor pregnancy outcomes due to underdevelopment, but it is believed that later negative consequences are more related to environmental factors such as a chaotic lifestyle and inadequate prenatal care. One of the crucial components is maternal care, which changes profoundly in addicted mothers. In substance-dependent mothers, pre- and postnatal care has special importance, and controlled treatment with a synthetic opioid (e.g., methadone) could be beneficial. We aimed to summarize and compare human and rodent data, as it is important to close the gap between scientific knowledge and societal policies. Special emphasis is given to gender differences in the sensitivity of offspring to perinatal opioid exposure.
阿片类药物是世界上已知最古老的药物之一，主要用于缓解疼痛，但也被广泛滥用。一个特别重要的问题是女性接触阿片类药物，因为她们的后代也可能受到影响。不利的宫内和产后环境会影响后代的发育，并可能导致以后生活中的各种残疾。很明显，反复的痛苦经历，如新生儿重症监护期间随机发生的侵入性手术，会永久性地改变神经元和突触的组织，从而影响以后的行为。与此同时，镇痛药物也可能是有害的，会导致新生儿神经元凋亡或戒断症状，以及成年后的行为改变。因此，当需要在怀孕期间或新生儿中缓解疼痛时，应该考虑风险效益比。阿片类药物的滥用也会改变生活的许多方面。宫内阿片类药物暴露会产生许多毒性作用，导致发育不良，妊娠结局不佳，但人们认为，以后的负面后果更多地与生活方式混乱和产前保健不足等环境因素有关。其中一个关键因素是母婴关系，在成瘾母亲中，母婴关系发生了深刻的变化。在依赖物质的母亲中，产前和产后护理具有特殊的重要性，用合成阿片类药物（如美沙酮）进行受控治疗可能是有益的。我们旨在总结和比较人类和啮齿动物的数据，因为弥合科学知识和社会政策之间的差距很重要。特别强调了后代对围产期阿片类药物暴露的敏感性存在性别差异。
