Methadone in pregnancy: treatment retention and neonatal outcomes.
OBJECTIVE
To examine the association between retention in methadone treatment during pregnancy and key neonatal outcomes.


METHODS
Client data from the New South Wales Pharmaceutical Drugs of Addiction System was linked to birth information from the NSW Midwives Data Collection and the NSW Inpatient Statistics Collection from 1992 to 2002.


METHODS
Obstetric and perinatal characteristics of women who were retained continuously on methadone maintenance throughout their pregnancy were compared to those who entered late in their pregnancies (less than 6 months prior to birth) and those whose last treatment episode ended at least 1 year prior to birth.


RESULTS
There were 2993 births to women recorded as being on methadone at delivery, increasing from 62 in 1992 to 459 births in 2002. Compared to mothers who were maintained continuously on methadone throughout their pregnancy, those who entered treatment late also presented later to antenatal services, were more likely to arrive at hospital for delivery unbooked, were more often unmarried, indigenous and smoked more heavily. A higher proportion of neonates born to late entrants were born at less than 37 weeks gestation and were admitted to special care nursery more often.


CONCLUSIONS
Continuous methadone treatment during pregnancy is associated with earlier antenatal care and improved neonatal outcomes. Innovative techniques for early engagement in methadone treatment by pregnant heroin using women or those planning to become pregnant should be identified and implemented.
Burns
Lucy
L
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia. l.burns@unsw.edu.au
Mattick
Richard P
RP
Lim
Kim
K
Wallace
Cate
C
D000328:Adult; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D009517:New South Wales / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D010349:Patient Compliance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000534:rehabilitation*; D011256:Pregnancy Outcome
D009294:Narcotics; D008691:Methadone