Rates and Clinical Implications of Transplacental Transfer of Neuraxial Fentanyl to Neonate

(Am J Obstet Gynecol. 2023;228(4):478–479) Epidural analgesia is widely used and accepted as a safe and effective method for pain management during labor and delivery. Though there is substantial research supporting this, there is also concern that some drugs can cross the placenta into the fetal blood stream. The main concern is the transmission of opioids across the placenta to the fetus during labor and before birth, thereby resulting in residual effects after birth. This study aimed to examine the frequency with which newborns test positive for fentanyl in their urine after the use of epidural analgesia, as well as assess factors that increase the likelihood of a positive test and the association between fentanyl positivity and clinical outcomes for the newborn.