title: Comparison of adverse obstetric outcomes and maternity hospitalization among heroin-exposed and methadone-treated women in Taiwan.
abstract: OBJECTIVE
  To identify sociodemographic and clinical factors predicting the overall risk of adverse obstetric outcomes and the length of maternal hospital stay among heroin-exposed and methadone-treated women in Taiwan.
  
  
  METHODS
  Using the retrospective matched cohort study design, 396 births to women on methadone treatment during pregnancy (the methadone-treated group) and 609 to women who started methadone treatment after childbirth (the heroin-exposed group) were identified in the National Methadone Maintenance Program. Adverse pregnancy outcomes were assessed by still birth, low birth weight and preterm delivery. We used multivariate methods and zero-truncated negative binomial regression to evaluate association estimates.
  
  
  RESULTS
  Both heroin-exposed and methadone-treated women had 2-4-fold greater risk of adverse pregnancy outcomes. HIV infection increased the overall risk of adverse pregnancy outcome in the methadone-treated group, whereas being unmarried and having treatment history of substance use disorders increased such risk in the heroin-exposed group. Maternal ages at delivery and healthcare facility used had moderate effects on the length of maternal hospital stay; HIV infection significantly increased the length of hospital stay for women in the heroin-exposed group (adjusted relative risk=1.32, 95% CI=1.05-1.68).
  
  
  CONCLUSIONS
  Our results showed no appreciable differences in the occurrence of adverse obstetric outcomes and the length of maternity hospitalization between the methadone-treated and the heroin-exposed women; the profile of sociodemographic and clinical predictors was similar as well. Coordination of addiction treatment and prenatal care may help reduce unfavorable obstetric outcomes among female heroin addicts seeking substitution treatment.
authors.affiliation: Institute of Public Health, National Yang-Ming University, Taiwan; Center of Neuropsychiatric Research, National Health Research Institutes, Taiwan. Electronic address: chuanychen@ym.edu.tw.
authors.forename: Chuan-Yu
authors.initials: CY
authors.lastname: Chen
authors.affiliation: Center of Neuropsychiatric Research, National Health Research Institutes, Taiwan.
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Lien
authors.affiliation: Department of Epidemiology and Biostatics, Michigan State University, USA.
authors.forename: Hsueh-Han
authors.initials: HH
authors.lastname: Yeh
authors.affiliation: Department of Addiction Science, Taipei City Psychiatric Centre, Taipei City Hospital, Taiwan.
authors.forename: Lien-Wen
authors.initials: LW
authors.lastname: Su
authors.affiliation: Center for Drug Abuse and Addiction, China Medical University and Graduate Institute of Clinical Medicine, China Medical University, Taiwan.
authors.forename: Ing-Kang
authors.initials: IK
authors.lastname: Ho
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006556:Heroin Dependence / Q000150:complications*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008691:Methadone / Q000008:administration & dosage* / Q000009:adverse effects; D015999:Multivariate Analysis; D058850:Opiate Substitution Treatment / Q000009:adverse effects / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: Low birth weight; Methadone; Pregnancy; Preterm