Variations in Infant CYP2B6 Genotype Associated with the Need for Pharmacological Treatment for Neonatal Abstinence Syndrome in Infants of Methadone-Maintained Opioid-Dependent Mothers.
BackgroundNeonatal abstinence syndrome (NAS) in infants of methadone-maintained opioid-dependent (MMOD) mothers cannot be predicted in individual cases. We investigated whether variation in infant genotype is associated with severity of NAS.MethodsThis is a pilot observational cohort study of 21 MMOD mothers and their newborns. Infant buccal swabs were obtained soon after delivery, together with a maternal blood sample for the determination of maternal plasma methadone concentration. Genomic variation in five opioid-related genes (ABCB1, COMT, CYP2B6, CYP2D6, andOPRM1) was ascertained from infant buccal swabs and related to need for pharmacological treatment of NAS.ResultsOut of 21 infants, 11 (52%) required treatment for NAS. Mothers of treated infants tended to have been prescribed higher doses of methadone, but plasma methadone concentrations did not differ between mothers of treated or untreated babies. Treated and untreated babies did not differ in terms of method of feeding. Treated infants were more likely to carry the normal (homozygous) allele at 516 and 785 regions ofCYP2B6gene (p= 0.015 and 0.023, respectively). There were no differences in any other genes between infants who did or did not require treatment for NAS.ConclusionGenomic variation inCYP2B6may explain, at least in part, severity of NAS.
Neonatal Unit, Princess Royal Maternity, Glasgow, United Kingdom.
Helen
H
Mactier
Department of Anthropology and Forensic Science, Bournemouth University, Fern Barrow, Poole, United Kingdom.
Poppy
P
McLaughlin
Neonatal Unit, Princess Royal Maternity, Glasgow, United Kingdom.
Cheryl
C
Gillis
Department of Anthropology and Forensic Science, Bournemouth University, Fern Barrow, Poole, United Kingdom.
Michael David
MD
Osselton
D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D015331:Cohort Studies; D065702:Cytochrome P-450 CYP2B6 / Q000235:genetics*; D005260:Female; D014644:Genetic Variation; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy / Q000209:etiology / Q000235:genetics*; D058850:Opiate Substitution Treatment / Q000009:adverse effects*; D009293:Opioid-Related Disorders / Q000150:complications* / Q000188:drug therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011297:Prenatal Exposure Delayed Effects / Q000209:etiology*; D006113:United Kingdom
D000701:Analgesics, Opioid; C585599:CYP2B6 protein, human; D065702:Cytochrome P-450 CYP2B6; D008691:Methadone