What is Kratom?
Kratom is the common name for Mitragyna speciosa, a tropical tree native to Indonesia, Malaysia, Papua New Guinea, Thailand and other parts of Southeast Asia. The leaves of a kratom tree have been traditionally used as a medicinal herb for hundreds of years in both Africa and Southeast Asia. Kratom leaves can be consumed chewed freshly plucked, dried, smoked like herbal teas and leafed products or made into an infusion [1].
This medicine contains psychoactive substances, which have stimulating and sedating effects depending on dosage. At small doses, they have stimulating effects, whereas, at high doses, there are analgesic (pain relief) and euphoric effects [2].
What does Kratom do?
Kratom is used in a variety of ways. It can be consumed to experience its stimulant effects and to substitute its opioid-like properties. It is used to treat pain conditions, curtail withdrawal from opioids, and as a fatigue suppressant [3, 4].
Aside from these, many use Kratom for mood enhancement, and dissipating anxiety and even for chronic pain relief [5]. But this potential upside has also been accompanied by an array of adverse effects.
These can be nausea, decreased appetite, fatigue, jaundice, and, in some extreme cases, psychiatric problems, such as psychosis, epileptic seizures and even death [1, 2, 3]. On the other hand, although Kratom could have some therapeutic applications, it’s inherently risky and should be taken with the highest caution.
Kratom and Pregnancy
Owing to its opioid agonist alkaloid content, Kratom is reportedly taken by pregnant women to alleviate pregnancy-related pain, anxiety, and depression, or to alleviate opioid withdrawal symptoms [6, 7]. Kratom use during pregnancy can lead to a wide range of health problems and side effects for both the mother and the offspring.
Is Kratom Safe During Pregnancy?
Withdrawal by both the mother and the infant following Kratom exposure has been reported, and both mothers and infants require pharmacological treatment [6]. Pregnant women with Kratom dependence have demonstrated opioid-like withdrawal symptoms and have been successfully treated with opioid replacement [7].
Babies born to mothers who have used Kratom during their pregnancy can have Neonatal Abstinence Syndrome (NAS), which is attributed to withdrawal from the drugs the baby was exposed to in the womb. In a case report, a female deliverer of a term neonate with severe NAS was determined to have daily ingestion of Kratom during pregnancy. Administration of oral phenobarbital successfully terminated it [8].
Although Kratom is frequently used for opioid dependence and withdrawal symptoms, there are no scientific studies that demonstrate its therapeutic and adverse effects. There are only a few cases of its use during pregnancy and its effects on the foetus-neonate [9].
Conclusion
In conclusion, Kratom administration, despite being portrayed as a safer option than opioids, can cause serious adverse events such as withdrawal symptoms, severity in the foetus, NAS symptoms of varying severity in the neonates, and other associated risks. It is of utmost importance that every maternal caretaker including all healthcare providers stay vigilant and proactive for Kratom dependence at the time of pregnancy and, if the episode reproduces, it is recommended to opt for a safer option such as non-pharmacological management.