Methadone and perinatal outcomes: a retrospective cohort study.

Abstract

OBJECTIVE:

The purpose of this study was to examine the relationship among methadone maintenance treatment, perinatal outcomes, and neonatal abstinence syndrome.

STUDY DESIGN:

This was a retrospective cohort study of 61,030 singleton births at a large maternity hospital from 2000-2007.

RESULTS:

There were 618 (1%) women on methadone at delivery. Methadone-exposed women were more likely to be younger, to book late for antenatal care, and to be smokers. Methadone exposure was associated with an increased risk of very preterm birth <32 weeks of gestation (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.40-4.34), being small for gestational age <10th percentile (aOR, 3.27; 95% CI, 2.49-4.28), admission to the neonatal unit (aOR, 9.14; 95% CI, 7.21-11.57), and diagnosis of a major congenital anomaly (aOR, 1.94; 95% CI, 1.10-3.43). There was a dose-response relationship between methadone and neonatal abstinence syndrome.

CONCLUSION:

Methadone exposure is associated with an increased risk of adverse perinatal outcomes, even when known adverse sociodemographic factors have been accounted for. Methadone dose at delivery is 1 of the determinants of neonatal abstinence syndrome.

• Authors: Brian J Cleary, Jean M Donnelly, Judith D Strawbridge, Paul J Gallagher, Tom Fahey, Martin J White, Deirdre J Murphy
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 204 Issue 2 Pg. 139.e1-9 (Feb 2011) ISSN: 1097-6868 [Electronic] United States
• PMID: 21145035 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Mosby, Inc. All rights reserved.

Chemical References

• Narcotics
• Methadone

Topics

• Age Factors
• Dose-Response Relationship, Drug
• Female
• Humans
• Infant, Newborn
• Methadone (adverse effects, therapeutic use)
• Narcotics (adverse effects, therapeutic use)
• Neonatal Abstinence Syndrome (diagnosis, etiology)
• Odds Ratio
• Opiate Substitution Treatment
• Opioid-Related Disorders (rehabilitation)
• Pregnancy
• Premature Birth (etiology)
• Retrospective Studies
• Risk Factors
• Smoking
• Treatment Outcome