Oxycodone administered as postpartum pain relief is associated with maternal report of infant central nervous system depression in breastfed infants
Bibliographic record
Abstract
Commentary on: Lam J, Kelly L, Ciszkowski C, et al. Central nervous system depression of neonates breastfed by mothers receiving oxycodone for postpartum analgesia. J Pediatr 2012; 160: 33– 7.e2.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] Despite our knowledge that codeine is excreted in breast milk, administration of codeine as a pain relief to breastfeeding mothers during the early postpartum period was considered safe until a healthy newborn died.1 The mother was an ultra-rapid metaboliser of codeine and thus, produced effectively the metabolite morphine. As a consequence, the guidelines for codeine use during breastfeeding were changed to include more caution about the possible central nervous system (CNS) depression effects on the neonate.2 As a result, many clinicians started to prescribe oxycodone, a semisynthetic opioid, instead. Little is known about the excretion of oxycodone into breast milk and the safety for newborns to mothers taking oxycodone while breastfeeding. Lam et al … [1]: {openurl}?query=rft.jtitle%253DThe%2BJournal%2Bof%2Bpediatrics%26rft.stitle%253DJ%2BPediatr%26rft.aulast%253DLam%26rft.auinit1%253DJ.%26rft.volume%253D160%26rft.issue%253D1%26rft.spage%253D33%26rft.epage%253D7.e2%26rft.atitle%253DCentral%2Bnervous%2Bsystem%2Bdepression%2Bof%2Bneonates%2Bbreastfed%2Bby%2Bmothers%2Breceiving%2Boxycodone%2Bfor%2Bpostpartum%2Banalgesia.%26rft_id%253Dinfo%253Adoi%252F10.1016%252Fj.jpeds.2011.06.050%26rft_id%253Dinfo%253Apmid%252F21880331%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/j.jpeds.2011.06.050&link_type=DOI [3]: /lookup/external-ref?access_num=21880331&link_type=MED&atom=%2Febmed%2F18%2F1%2F40.atom [4]: /lookup/external-ref?access_num=000298143000011&link_type=ISI
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Commentary About the Canadian research system: no · About a Canadian topic: no | Other design | high |
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedLabeled directly by 2 models reading the full record.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".