Higher maternal doses of methadone does not increase neonatal abstinence syndrome.
OBJECTIVE
The purpose of this study is to assess the incidence of clinically significant neonatal abstinence syndrome (NAS) based on maternal antenatal methadone dosing in women with a history of narcotic dependence.


METHODS
A retrospective review of 174 pregnant women on methadone maintenance was performed. Data were stratified based on maternal methadone dose at delivery: low (0-50 mg/day, n = 59), medium (51-100 mg/day, n = 63), and high (>100 mg/day, n = 52). NAS was defined by Finnegan as score greater than 7 on two occasions. Outcome measures were rate and severity of NAS, birth weight, preterm birth rate, and neonatal morbidities and mortality.


RESULTS
The rates of NAS (40.7% vs. 52.4% vs. 40.8%, p > .05), birth weight, and neonatal morbidities were similar regardless of the maternal methadone dose. Although there was a trend toward earlier delivery, the rate of preterm birth among the three groups (low dose, 17%; medium dose, 19%; high dose, 27%; p > .05) was not statistically significant.


CONCLUSIONS
Higher maintenance dosing of methadone is not associated with increased rate or severity of NAS or other adverse perinatal outcomes. Concerns about NAS should not restrict the methadone dosing during pregnancy. Methadone dosing should not be restricted to lower dosing during pregnancy.
Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, OH, USA.
David
D
Pizarro
Mounira
M
Habli
Marquia
M
Grier
Annette
A
Bombrys
Baha
B
Sibai
Jeffrey
J
Livingston
D000328:Adult; D001724:Birth Weight / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008691:Methadone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology* / Q000209:etiology; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000534:rehabilitation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
D009294:Narcotics; D008691:Methadone