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Methadone, Pierre Robin sequence and other congenital anomalies: case-control study
Brian Cleary1,2, Maria Loane3, Marie-Claude Addor4
1Pharmacy Department, Rotunda Hospital, Dublin, Ireland.
Summary
Gestational methadone exposure is linked to Pierre Robin sequence (PRS), a rare condition. While the risk increase is small, it warrants further investigation, especially concerning cleft palate associations.
Area of Science:
- Obstetrics and Gynecology
- Teratology
- Genetics and Genomics
Background:
- Opioid use disorder in pregnancy necessitates treatment with methadone.
- Previous studies indicated a potential link between prenatal methadone exposure and Pierre Robin sequence (PRS).
Purpose of the Study:
- To investigate the association between methadone exposure during pregnancy and the occurrence of Pierre Robin sequence (PRS).
Main Methods:
- A case-malformed control study utilized European Surveillance of Congenital Anomalies registries from 1995-2011.
- Cases included PRS diagnoses, while controls comprised other congenital anomalies, excluding genetic conditions.
- Methadone exposure was confirmed via medical records and maternal interviews.
Main Results:
- An association was observed between gestational methadone exposure and PRS (adjusted OR 12.3).
- This translates to a small absolute risk increase, approximately 1-12 cases per 10,000 births.
- A heightened association was also noted for cleft palate (adjusted OR 5.0).
Conclusions:
- Gestational methadone exposure appears associated with PRS, potentially influenced by unmeasured confounding factors.
- The observed small increase in PRS risk does not significantly alter the risk-benefit profile of methadone treatment in pregnancy.
- Further research is recommended to validate the association with cleft palate using independent data.
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