title: Neonatal visual evoked potentials in infants born to mothers prescribed methadone.
abstract: OBJECTIVE
  Drug misuse in pregnancy is associated with impaired infant visual development. Pilot data showed abnormal flash visual evoked potentials (VEPs) in neonates exposed to methadone in utero, but results were confounded by intrauterine growth restriction, gestation, and ongoing drug misuse. This large cohort study aimed to clarify the effects on neonatal flash VEPs of maternal drug misuse in pregnancy, including prescription of substitute methadone and subsequent development of neonatal abstinence syndrome.
  
  
  METHODS
  This was a prospective cohort study. Flash VEPs were recorded within 3 days of birth from 100 healthy infants of drug-misusing mothers prescribed substitute methadone during pregnancy and 50 comparison infants matched for birth weight, gestation, and socioeconomic deprivation. VEP morphology was classified as mature, typical, or immature, and amplitudes and implicit times of the major waveform components measured. Drug exposure was determined by maternal history, maternal and infant urine, and meconium toxicology.
  
  
  RESULTS
  VEPs from maternal drug-exposed infants were more likely to be of immature waveform (P < .001) and were smaller in overall amplitude (median 27 µV vs 39 µV, P < .001) compared with non-drug-exposed infants. Most infants were exposed to illicit drugs in addition to prescribed methadone; differences in VEP parameters were independently associated with maternal prescribed methadone and persisted after correcting for birth weight, cigarette smoking, and excess in utero alcohol exposure.
  
  
  CONCLUSIONS
  In utero exposure to prescribed substitute methadone is associated with altered flash VEPs in the newborn period and these infants may warrant early clinical visual assessment.
authors: Princess Royal Maternity, Glasgow, United Kingdom. lauramcglone@doctors.org.uk
authors: Laura
authors: L
authors: McGlone
authors: Ruth
authors: R
authors: Hamilton
authors: Daphne L
authors: DL
authors: McCulloch
authors: Richard
authors: R
authors: Boulton
authors: Michael S
authors: MS
authors: Bradnam
authors: Lawrence T
authors: LT
authors: Weaver
authors: Helen
authors: H
authors: Mactier
mesh_terms: D015331:Cohort Studies; D005074:Evoked Potentials, Visual / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn / Q000254:growth & development; D008297:Male; D008691:Methadone / Q000009:adverse effects*; D010865:Pilot Projects; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D011446:Prospective Studies
chemical_list: D008691:Methadone