Outpatient methadone programme for pregnant heroin using women

A prospective study of pregnant narcotic users who attended the antenatal clinic at Westmead Hospital was undertaken to determine the practicality and safety of an outpatient methadone programme for these women. Forty-six women were commenced and managed on a methadone maintenance programme based at the Drug and Alcohol Clinic at Westmead Hospital (GROUP I), 12 women were maintained on long-term methadone therapy by outside prescribers (GROUP II), 12 women not on methadone continued to use heroin through the pregnancy (GROUP III), 14 women used heroin intermittently (GROUP IV). These were compared with a group of 52 women who were non-drug using (GROUP V). Women on the hospital based methadone programme had an earlier first antenatal clinic visit (p less than 0.001) than those women on outside methadone programmes or on heroin and had a longer pregnancy (p less than 0.001) than those women on heroin. The birth-weights on babies delivered to women on the Westmead Methadone Programme were significantly higher than those on babies born to women using heroin (p less than 0.05). A disappointing aspect of the study was a lower number of antenatal clinic visits (p less than 0.001) for all narcotic using women when compared with the comparison group. The outcome of the Westmead Methadone Programme women showed that better maternal and neonatal outcome followed entry into a hospital monitored methadone programme with attendant antenatal care.