Kratom, a plant-based substance from the Mitragyna speciosa tree, originates from Southeast Asian countries such as Malaysia, Thailand, and Indonesia. Related to the coffee plant, it is consumed as powders, capsules, or teas. In the U.S., kratom is widely available as a dietary supplement and is not regulated like prescription medications. While some use kratom for pain, anxiety, depression, or opioid withdrawal, its use during pregnancy raises significant public health concerns.
Kratom and Pregnancy: Understanding the Risks
Current scientific understanding of kratom’s effects during pregnancy is limited, primarily based on case reports rather than extensive clinical trials. Its active compounds, mitragynine and 7-hydroxymitragynine, interact with opioid receptors, producing opioid-like effects. These compounds readily cross the placenta, directly exposing the developing fetus. The FDA notes that many kratom compounds bind to opioid receptors, confirming its opioid-like activity.
Maternal kratom use during pregnancy carries several health risks. Users may develop physical dependence and addiction, similar to opioid dependence. Reported maternal side effects include liver issues, seizures, nausea, vomiting, weight loss, constipation, increased urination, dry mouth, dizziness, delusions, confusion, depression, or suppressed breathing. Additionally, kratom products have been found contaminated with harmful substances like heavy metals (e.g., lead) and dangerous bacteria (e.g., Salmonella), which can cause severe illness or even death.
For the unborn baby, prenatal kratom exposure presents distinct risks. The substance’s passage across the placenta can lead to complications like being born too small or too early. There is also a possibility of liver complications or disorders developing in the sensitive fetal liver. Kratom in any form is generally not considered safe for use during pregnancy.
Maternal and Neonatal Withdrawal Concerns
Regular kratom use can lead to physical dependence. If use is abruptly stopped, the mother may experience withdrawal symptoms similar to opioid withdrawal. These include anxiety, insomnia, nausea, vomiting, abdominal pain, muscle aches, sweating, irritability, depression, jerky movements, difficulty concentrating, intense cravings, runny nose, and tremors. Symptoms typically begin 6 to 12 hours after the last dose, peak within one to three days, and acute physical symptoms subside within a week. Psychological symptoms like anxiety and depression can persist for several weeks or longer.
A significant concern is the risk of Neonatal Abstinence Syndrome (NAS) or Neonatal Opioid Withdrawal Syndrome (NOWS) in newborns. This occurs when a baby experiences withdrawal after in-utero substance exposure. Kratom has been identified as a cause, leading to a rise in NAS cases. Newborn symptoms include high-pitched crying, irritability, fussiness, jitteriness, tremors, irregular respiratory patterns, skin mottling, reduced appetite, and sneezing.
Diagnosing kratom-induced NAS is complex because standard urine drug screens do not detect kratom metabolites; specialized chromatography testing is often required to confirm its presence. Many cases are identified postpartum when infants show withdrawal symptoms. Medical intervention is frequently necessary, often involving pharmacological management with medications such as morphine or methadone to help stabilize the newborn and gradually wean them off the substance. Clonidine has also been utilized in some cases to manage symptoms.
Navigating Kratom Use During Pregnancy
Pregnant individuals using kratom, or considering its use, should consult a healthcare provider, such as a doctor, obstetrician, or an addiction specialist. Medical guidance allows for a personalized assessment and the development of a safe management plan.
Stopping kratom abruptly during pregnancy is not advisable without medical supervision, as sudden cessation poses risks for both the mother and the developing baby. Healthcare providers can assist in formulating a safe tapering plan or a management strategy tailored to the individual’s needs. Approaches may involve opioid agonist treatments, such as buprenorphine or morphine, or medically supervised detoxification programs. These strategies minimize withdrawal symptoms and ensure the well-being of both the pregnant individual and the fetus. For those struggling with substance use, addiction treatment centers offer essential medical detoxification and ongoing support programs.