The management of heroin misuse in pregnancy: time for a rethink?
Heroin use in pregnancy is a worldwide problem. Methadone maintenance treatment has definite advantages for the mother and is currently recommended in the UK. There is, however, increasing evidence of adverse effects upon developing cortical and visual function in children of treated heroin-addicted mothers. The longer-term implications of this are not yet clear, and are confounded by poly-drug misuse and ongoing social deprivation. There is a paucity of evidence regarding outcome for infants who require pharmacological treatment for neonatal abstinence syndrome compared to those who have only mild symptoms. Well-controlled studies of the treatment of heroin misuse in pregnancy that take account of both neonatal and longer term outcomes for the child are urgently required.
Mactier
Helen
H
Neonatal Unit, Princess Royal Maternity, 8-16 Alexandra Parade, Glasgow G31 2ER, Scotland. helen.mactier@ggc.scot.nhs.uk
D002047:Buprenorphine / Q000627:therapeutic use; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000139:chemically induced; D005260:Female; D006556:Heroin Dependence / Q000150:complications / Q000534:rehabilitation*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008431:Maternal-Fetal Exchange; D008691:Methadone / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000534:rehabilitation*; D011295:Prenatal Care / Q000379:methods; D011297:Prenatal Exposure Delayed Effects
D002047:Buprenorphine; D008691:Methadone