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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
High-dose methadone maintenance in pregnancy: maternal and neonatal outcomes
John J McCarthy1, Martin H Leamon, Michael S Parr
1Bi-Valley Medical Clinic, Sacramento, CA, USA. jmccarthy@bivalley.com
Objective:
This study assesses the effect of higher doses of methadone during pregnancy on maternal and fetal outcomes.
Study Design:
We retrospectively reviewed clinical data for 81 mothers who received methadone and their 81 offspring. The cohort was divided into high-dose (>/=100 mg) and low-dose (<100 mg) groups.
Results:
There were no differences in the rate of medication treatment for neonatal abstinence symptoms or days of infant hospitalization between the high-dose (mean, 132 mg) and low-dose (mean, 62 mg) groups. Despite longer histories of opiate abuse, the high-dose group had less illicit drug use at delivery. The whole cohort, which received an average of 101 mg/d, had an 81% rate of negative toxicology screens at delivery.
Conclusion:
High doses of methadone were not associated with increased risks of neonatal abstinence symptoms but had a positive effect on maternal drug abuse. Arbitrarily limiting methadone dose as a way of minimizing the risks of neonatal abstinence symptoms may be unwarranted.
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