Methadone and perinatal outcomes: a prospective cohort study
Cleary BJ et al. – The incidence and duration of the neonatal abstinence syndrome is not associated with maternal methadone dose, but maternal opiate, benzodiazepine or cocaine use is associated with longer neonatal hospitalization.Methods
- Prospective cohort study.
- Two tertiary care maternity hospitals.
- A total of 117 pregnant women on methadone maintenance treatment recruited between July 2009 and July 2010.
- Information on concomitant drug use was recorded with the Addiction Severity Index.
- Perinatal outcomes included pre–term birth (<37 weeks' gestation), small–for–gestational–age (<10th centile) and neonatal unit admission.
- NAS outcomes included: incidence of medically treated NAS, peak Finnegan score, cumulative dose of NAS treatment and duration of hospitalization.
- Of the 114 liveborn infants 11 (9.6%) were born pre–term, 49 (42.9%) were small–for–gestational–age, 56 (49.1%) had a neonatal unit admission and 29 (25.4%) were treated medically for NAS.
- Neonates exposed to methadone–only had a shorter hospitalization than those exposed to methadone and concomitant drugs (median 5.0 days versus 6.0 days, P = 0.03).
- Neonates exposed to methadone doses ≥80 mg required higher cumulative doses of morphine treatment for NAS (median 13.2 mg versus 19.3 mg, P = 0.03).
- The incidence and duration of NAS did not differ between the two dosage groups.