High-dose methadone maintenance in pregnancy: maternal and neonatal outcomes.
OBJECTIVE
This study assesses the effect of higher doses of methadone during pregnancy on maternal and fetal outcomes.


METHODS
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.


CONCLUSIONS
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.
McCarthy
John J
JJ
Bi-Valley Medical Clinic, Sacramento, CA, USA. jmccarthy@bivalley.com
Leamon
Martin H
MH
Parr
Michael S
MS
Anania
Barbara
B
D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008691:Methadone / Q000008:administration & dosage*; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000534:rehabilitation*; D011256:Pregnancy Outcome
D000701:Analgesics, Opioid; D008691:Methadone