title: Auricular acupuncture for chemically dependent pregnant women: a randomized controlled trial of the NADA protocol.
abstract: BACKGROUND
  The prevalence of maternal drug use during pregnancy in North America has been estimated to be as high as 6-10%. The consequences for the newborn include increased risk for perinatal mortality and ongoing physical, neurobehavioral, and psychosocial problems. Methadone is frequently used to wean women off street drugs but is implicated as a cause of adverse fetal/neonatal outcomes itself. The purpose of our study was to test the ability of maternal acupuncture treatment among mothers who use illicit drugs to reduce the frequency and severity of withdrawal symptoms among their newborns.
  
  
  METHODS
  We randomly assigned chemically dependent pregnant women at BC Women's Hospital in Vancouver, British Columbia to daily acupuncture treatments versus usual care. By necessity, neither our participants nor acupuncturists were blinded as to treatment allocation. Our primary outcome was days of neonatal morphine treatment for symptoms of neonatal withdrawal. Secondary neonatal outcomes included admission to a neonatal ICU and transfer to foster care.
  
  
  RESULTS
  We randomized 50 women to acupuncture and 39 to standard care. When analyzed by randomized groups, we did not find benefit of acupuncture; the average length of treatment with morphine for newborns in the acupuncture group was 2.7 (6.3) compared to 2.8 (7.0) in the control group. Among newborns of women who were compliant with the acupuncture regime, we observed a reduction of 2.1 and 1.5 days in length of treatment for neonatal abstinence syndrome compared to the non-compliant and control groups, respectively. These differences were not statistically significant.
  
  
  CONCLUSIONS
  Acupuncture may be a safe and feasible treatment to assist mothers to reduce their dosage of methadone. Our results should encourage ongoing studies to test the ability of acupuncture to mitigate the severity of neonatal abstinence syndrome among their newborns.
authors.affiliation: School of Population and Public Health, Child and Family Research Institute, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T-1Z3. patti.janssen@ubc.ca
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Janssen
authors.forename: Louise C
authors.initials: LC
authors.lastname: Demorest
authors.forename: Anne
authors.initials: A
authors.lastname: Kelly
authors.forename: Paul
authors.initials: P
authors.lastname: Thiessen
authors.forename: Ron
authors.initials: R
authors.lastname: Abrahams
mesh_terms: D020831:Acupuncture, Ear; D000328:Adult; D005260:Female; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D007231:Infant, Newborn; D009020:Morphine / Q000627:therapeutic use; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D019966:Substance-Related Disorders / Q000150:complications* / Q000628:therapy*; D016387:Women's Health
chemical_list: D013287:Illicit Drugs; D009020:Morphine