title: Newborn birth-weight of pregnant women on methadone or buprenorphine maintenance treatment: A national contingency management approach trial.
abstract: OBJECTIVE
  Methadone maintenance treatment (MMT) is the gold standard for pregnant women with opioid use disorders. Still, low birth-weights were reported, in particular of mothers who became pregnant before admission to MMT. We studied whether an escalating incentive contingency-management approach may contribute to better newborn birth-weights.
  
  
  METHODS
  A nationwide controlled randomized trial among all Israeli methadone/buprenorphine maintenance treatment (MBMT), newly or already in treatment pregnant women was performed. A modified contingency-management protocol with coupons of escalating value depending upon reduction of drug use, cigarette smoking, and alcohol consumption was compared to standard care arm. Drugs in urine, smoking (Fagerstrom score), alcohol use, and depression were monitored.
  
  
  RESULTS
  Thirty-five women had 46 pregnancies. In their first pregnancy, 19 from the contingency-management and 16 from the standard care arms were studied. Contingency-management group as compared to the standard care arm included more newly admitted women (36.8% vs. 6.3%, p = .05), with benzodiazepine and cannabis onset at a younger age, and higher proportion of any drug abuse while pregnant (100% vs. 68.8%, p = .01). Fifteen of the contingency-management and 14 of the control arm gave birth (78.9% vs. 87.5%, p = .3) with similar proportions of normal (>2,500 g) birth-weight (71.4% vs. 61.5%, p = .8).
  
  
  CONCLUSIONS
  Newborns' birth-weight was comparable among the two study arms indicating no contribution of the contingency-management approach. Small sample and baseline differences between arms might have influenced results. Intensive intervention should be evaluated on a larger scale of participants. (Am J Addict 2017;26:167-175).
authors.affiliation: Dr Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Einat
authors.initials: E
authors.lastname: Peles
authors.affiliation: Dr Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Anat
authors.initials: A
authors.lastname: Sason
authors.affiliation: Dr Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.|Department of Psychiatry, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Shaul
authors.initials: S
authors.lastname: Schreiber
authors.affiliation: Dr Miriam and Sheldon G. Adelson Clinic for Drug Abuse, Treatment and Research, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Miriam
authors.initials: M
authors.lastname: Adelson
mesh_terms: D000328:Adult; D017668:Age of Onset; D000428:Alcohol Drinking / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D001724:Birth Weight / Q000187:drug effects*; D002047:Buprenorphine / Q000008:administration & dosage / Q000009:adverse effects; D000073865:Cigarette Smoking / Q000009:adverse effects / Q000453:epidemiology; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D008691:Methadone / Q000008:administration & dosage / Q000009:adverse effects; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects; D058850:Opiate Substitution Treatment / Q000379:methods / Q000706:statistics & numerical data; D009293:Opioid-Related Disorders / Q000150:complications / Q000188:drug therapy; D010346:Patient Care Management / Q000379:methods / Q000458:organization & administration; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D009294:Narcotics; D002047:Buprenorphine; D008691:Methadone