title: Relationship between maternal methadone dose at delivery and neonatal abstinence syndrome.
abstract: OBJECTIVE
  To estimate the relationship between maternal methadone dose and the incidence of neonatal abstinence syndrome (NAS).
  
  
  METHODS
  We performed a retrospective cohort study of pregnant women treated with methadone for opiate addiction who delivered live-born neonates between 1996 and 2006. Four dose groups, on the basis of total daily methadone dose, were compared (<or=80 mg/d, 81-120 mg/d, 121-160 mg/d, and >160 mg/d). The primary outcome was treatment for NAS. Symptoms of NAS were objectively measured with the Finnegan scoring system, and treatment was initiated for a score>24 during the prior 24 hours.
  
  
  RESULTS
  A total of 330 women treated with methadone and their 388 offspring were included. Average methadone dose at delivery was 117+/-50 mg/d (range, 20-340 mg/d). Overall, 68% of infants were treated for NAS. Of infants exposed to methadone doses<or=80 mg/d, 81-120 mg/d, 121-160 mg/d, and >160 mg/d, treatment for NAS was initiated for 68%, 63%, 70%, and 73% of neonates, respectively (P=.48). The rate of maternal illicit opiate abuse at delivery was 26%, 28%, 19%, and 11%, respectively (P=.04).
  
  
  CONCLUSIONS
  No correlation was found between maternal methadone dose and rate of NAS. However, higher doses of methadone were associated with decreased illicit opiate abuse at delivery.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA. n.seligman@hotmail.com
authors.forename: Neil S
authors.initials: NS
authors.lastname: Seligman
authors.forename: Christopher V
authors.initials: CV
authors.lastname: Almario
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Hayes
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Dysart
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
authors.forename: Jason K
authors.initials: JK
authors.lastname: Baxter
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008691:Methadone / Q000008:administration & dosage*; D009294:Narcotics / Q000008:administration & dosage*; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D009294:Narcotics; D008691:Methadone