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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Methadone and perinatal outcomes: a retrospective cohort study
Brian J Cleary1, Jean M Donnelly, Judith D Strawbridge
1Department of Obstetrics and Gynecology, Trinity College Dublin, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland. bcleary@coombe.ie
American Journal of Obstetrics and Gynecology
|December 15, 2010
Summary
Methadone maintenance treatment during pregnancy increases risks for preterm birth, fetal growth restriction, and neonatal unit admission. Higher methadone doses correlate with neonatal abstinence syndrome severity.
Area of Science:
- Obstetrics and Gynecology
- Neonatalogy
- Pharmacology
Background:
- Methadone maintenance treatment (MMT) is a standard for opioid use disorder in pregnancy.
- Perinatal outcomes and neonatal abstinence syndrome (NAS) in MMT pregnancies require careful evaluation.
Purpose of the Study:
- To investigate the associations between MMT, perinatal results, and NAS.
- To determine if MMT is independently linked to adverse pregnancy outcomes.
Main Methods:
- Retrospective cohort study.
- Analysis of 61,030 singleton births between 2000-2007.
- Comparison of outcomes between women on methadone and those not.
Main Results:
- Methadone exposure was linked to higher rates of very preterm birth, small for gestational age infants, neonatal unit admission, and major congenital anomalies.
- A dose-response relationship was observed between maternal methadone dose and NAS severity.
- Methadone-exposed women had higher rates of late antenatal booking and smoking.
Conclusions:
- MMT is associated with increased risks of adverse perinatal outcomes, independent of sociodemographic factors.
- Maternal methadone dosage is a key factor in the development and severity of NAS.
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