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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

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Published on: August 25, 2014

Maternal methadone dosing schedule and fetal neurobehaviour.

Lauren M Jansson¹, Janet A Dipietro, Martha Velez

¹Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. ljansson@jhmi.edu

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

|December 17, 2008

Summary

Split-dosing methadone in pregnant women appears to reduce fetal neurobehavioural suppression compared to single-dosing. This dosing strategy may offer benefits for opiate-dependent pregnancies.

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Area of Science:

Obstetrics and Gynecology
Neonatal Neurobehavior
Pharmacology

Background:

Daily methadone maintenance is standard for pregnant women with opiate dependency.
Previous studies show single-dose methadone suppresses fetal neurobehavior.

Purpose of the Study:

To compare the impact of single-dose versus split-dose maternal methadone administration on fetal neurobehavior.

Main Methods:

Forty pregnant women on methadone maintenance were assessed at 36-37 weeks gestation.
Fetal neurobehavior and maternal physiology were monitored under single- and split-dosing schedules.
Fetal measures included heart rate, variability, accelerations, motor activity, and fetal movement-heart rate coupling (FM-FHR).

Main Results:

Maternal methadone suppressed fetal neurobehavior in both dosing regimens.
Fetal parameters were significantly lower at peak levels during single-dosing compared to split-dosing.
Fetal movement-heart rate coupling showed less suppression from trough to peak with split-dosing.

Conclusions:

Split-dosing methadone resulted in less fetal neurobehavioral suppression compared to single-dosing.
Split-dosing may be a beneficial approach for methadone-maintained pregnant women.