[Substitution treatment of drug addicts during pregnancy: consequences for the children?].
BACKGROUND
Substitution treatment of opioid-dependent addicts was introduced in Norway in 1998. During the last 10 years, approximately 150 infants have been born to mothers taking part in this programme.


METHODS
10 mothers, who took part in the substitution treatment programme, gave birth to 15 infants at Haukeland University Hospital in the period 1999-2005. The infants were observed and monitored at the Department of Pediatrics, Haukeland University Hospital.


RESULTS
During pregnancy, six of the infants were only exposed to opiates, i.e methadone or buprenorphine. Eight infants were also exposed to heroine, benzodiazepines or cannabis. As a group, these infants had lower birth weight than the national average. 14 of the 15 children developed neonatal abstinence syndrome (NAS), 10 needed treatment and two children died from sudden infant death syndrome (SIDS). Long-term follow-up showed that six of 13 children had normal psychomotor development, five had various degrees of delayed psychomotor development and two children had symptoms indicating a hyperkinetic disorder. Five children were in foster care.


CONCLUSIONS
Infants of women included in substitution treatment programmes for drug addicts are at high risk compared to infants of women without such addiction. For the newborn, NAS was a frequent complication. The study also showed that symptoms of hyperkinetic disorder and delayed psychomotor development were common. Children who had been exposed to opiates in combination with additional drugs seemed to have a high risk of delayed development and behaviour disorders. As they get older many were placed in foster care, despite well-coordinated, multidisciplinary treatment for the mother.
Sandtorv
Lisbeth
L
Barneklinikken, Haukeland universitetssykehus, 5021 Bergen.
Reigstad
Hallvard
H
Bruarøy
Sidsel
S
Elgen
Irene
I
Laegreid
Liv Marie
LM
D002047:Buprenorphine / Q000008:administration & dosage / Q000009:adverse effects; D002658:Developmental Disabilities / Q000139:chemically induced; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008691:Methadone / Q000008:administration & dosage / Q000009:adverse effects; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects*; D009357:Neonatal Abstinence Syndrome / Q000209:etiology; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000534:rehabilitation*; D011297:Prenatal Exposure Delayed Effects; D011596:Psychomotor Disorders / Q000139:chemically induced; D012307:Risk Factors
D009294:Narcotics; D002047:Buprenorphine; D008691:Methadone