title: The obstetrical and neonatal impact of maternal opioid detoxification in pregnancy.
abstract: OBJECTIVE
  The purpose of this study was to analyze the obstetric and neonatal impact of an opioid detoxification program during pregnancy, as well as to examine variables associated with successful opioid detoxification.
  
  
  METHODS
  This is a retrospective cohort study of women electing inpatient detoxification and subsequently delivering at our hospital from Jan. 1, 2006, through Dec. 31, 2011. Detoxification was considered successful if women had no illicit drug supplementation at the time of delivery. Maternal characteristics were ascertained by chart review and analyzed for variables associated with success. Obstetric and neonatal outcomes were also assessed based on maternal success at delivery.
  
  
  RESULTS
  Of the 95 women during the study period with complete data, 53 (56%) were successful. There were no demographic or social risk factors identified associated with success. Women with successful detoxification at delivery had longer inpatient detoxification admissions (median 25 vs 15 days, P < .001) and were less likely to leave prior to completion of the program than women who had relapsed at delivery (9% vs 33%, respectively, P < .001). Infants of mothers who were successfully detoxified had shorter hospitalizations (median 3 vs 22 days, P < .001), lower maximum neonatal abstinence syndrome scores (0 vs 8.3, P < .001), and were less likely to be treated for withdrawal (10% vs 80%, P < .001).
  
  
  CONCLUSIONS
  Opiate detoxification in pregnancy requires a significant time commitment and extended treatment, however, can be successfully achieved in compliant parturients. Importantly, maternal demographics and drug histories do not portend success, supporting continued opiate detoxification being offered to all women expressing intent.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Stewart
authors.forename: David B
authors.initials: DB
authors.lastname: Nelson
authors.forename: Emily H
authors.initials: EH
authors.lastname: Adhikari
authors.forename: Donald D
authors.initials: DD
authors.lastname: McIntire
authors.forename: Scott W
authors.initials: SW
authors.lastname: Roberts
authors.forename: Jodi S
authors.initials: JS
authors.lastname: Dashe
authors.forename: Jeanne S
authors.initials: JS
authors.lastname: Sheffield
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008691:Methadone / Q000627:therapeutic use*; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D008691:Methadone
keywords: drug use in pregnancy; methadone detoxification; opioid detoxification