NEWTT2 FAQs: Opioids

How are centres interpreting the use of maternal opioids less than 6 hours before delivery? Should this include all opioids or just those delivered intramuscularly/ intravenously?

Monitoring of newborns following maternal opiate administration focused on maternal pethidine less than 6 hours before delivery in NEWTT 2015. This now requires expanding to include other opiates currently in use. Observations are required for maternal IV/IM opiate use less than 6 hours prior to birth. 

There is no current indication to routinely observe newborns where the maternal opiate exposure is limited to spinal or epidural administration. There are reports of oral opiates affecting the newborn but national guidance/consensus is less clear. NEWTT2 provides a platform for local, national and regional guidance and has not been able to make firm recommendations where no national guidance exists. 

We recommend that  local unit guidance is followed for maternal use of oral opiates as pain relief.