- For newborns exposed to opioids in utero, evidence remains insufficient to support naloxone (e.g., Narcan) use with cardiorespiratory or neurological depression.
- Naloxone for infants chronically exposed in utero has not been assessed; trial results for acute exposure during birth show no compelling effects on outcomes.
- All included trials are >30 years old.
Why this matters
- The opioid antagonist naloxone can be used for newborns suffering adverse effects of in utero opioid exposure, but benefits vs harms are unclear.
- Review updates a 2013 Cochrane report by the same group, with no new trials added or new conclusions, despite ongoing threats of the opioid epidemic.
- None of the trials specifically included infants with respiratory or neurological depression.
- None examined infants whose mothers had used opioids while pregnant.
- The authors cite “some evidence” of benefit of naloxone for alveolar ventilation in trials measuring respiratory function within 6 hours of birth.
- No trial evaluated child development over the long term.
- Cochrane review, 9 trials included, all of them more than 30 years old, and quite small, with only 316 infants total.
- Funding: University of York; UK National Institute for Health Research; Vermont Oxford Network, USA.
- Very old, small trials.