title: The effect of prenatal alcohol co-exposure on neonatal abstinence syndrome in infants born to mothers in opioid maintenance treatment.
abstract: OBJECTIVE
  This study examined the effects of prenatal alcohol exposure (PAE) on the incidence and severity of neonatal abstinence syndrome (NAS).
  
  
  METHODS
  For this pilot study, 70 pregnant women on opioid maintenance therapy (OMT) were recruited from a perinatal substance abuse clinic. Subjects were categorized into three study groups based on the timing of alcohol use during pregnancy as assessed by repeated self-reported measures and a comprehensive panel of ethanol biomarkers. NAS outcomes included: duration of hospital stay, the need for pharmacological treatment of NAS, newborn age at the initiation of NAS treatment, duration of treatment and cumulative methadone dose administered.
  
  
  RESULTS
  The study included a large proportion of ethnic minorities (81.4% Hispanic, 5.7% American Indian), women with less than a high school education (52.2%) and unplanned pregnancy (82.9%). In multivariate analysis, PAE was not associated with NAS outcomes; however, one newborn diagnosed with fetal alcohol syndrome (FAS) demonstrated much more severe NAS compared to other PAE infants. Interestingly, 3rd trimester PAE was associated with a higher prevalence of microcephaly (62.5%) compared to the PAE abstaining group (36.8%; p = 0.08).
  
  
  CONCLUSIONS
  In this study, PAE was not associated with NAS severity; however, further examination in a larger study is needed.
authors.affiliation: a Department of Pharmacy Practice and Administrative Sciences , College of Pharmacy and.
authors.forename: Christine
authors.initials: C
authors.lastname: Kreitinger
authors.affiliation: a Department of Pharmacy Practice and Administrative Sciences , College of Pharmacy and.
authors.forename: Hilda
authors.initials: H
authors.lastname: Gutierrez
authors.affiliation: a Department of Pharmacy Practice and Administrative Sciences , College of Pharmacy and.
authors.forename: Ajna
authors.initials: A
authors.lastname: Hamidovic
authors.affiliation: a Department of Pharmacy Practice and Administrative Sciences , College of Pharmacy and.|b Department of Family and Community Medicine , School of Medicine, University of New Mexico , Albuquerque , NM , USA .
authors.forename: Cheryl
authors.initials: C
authors.lastname: Schmitt
authors.affiliation: c Department of Pharmacy , University of New Mexico Hospital , Albuquerque , NM , USA , and.
authors.forename: Preeyaporn
authors.initials: P
authors.lastname: Sarangarm
authors.affiliation: d Department of Obstetrics and Gynecology , School of Medicine, University of New Mexico , Albuquerque , NM , USA.
authors.forename: William F
authors.initials: WF
authors.lastname: Rayburn
authors.affiliation: b Department of Family and Community Medicine , School of Medicine, University of New Mexico , Albuquerque , NM , USA .|d Department of Obstetrics and Gynecology , School of Medicine, University of New Mexico , Albuquerque , NM , USA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Leeman
authors.affiliation: a Department of Pharmacy Practice and Administrative Sciences , College of Pharmacy and.|b Department of Family and Community Medicine , School of Medicine, University of New Mexico , Albuquerque , NM , USA .
authors.forename: Ludmila N
authors.initials: LN
authors.lastname: Bakhireva
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008691:Methadone / Q000627:therapeutic use; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000453:epidemiology*; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D008691:Methadone
keywords: Alcohol; methadone; neonatal abstinence syndrome; opioids; pregnancy