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High-dose methadone in pregnant women and its effect on duration of neonatal abstinence syndrome

Published:November 03, 2008DOI:https://doi.org/10.1016/j.ajog.2008.08.041

      Objective

      The purpose of this study was to examine high-dose methadone in pregnant women and its effect on the duration of neonatal abstinence syndrome.

      Study Design

      This was a retrospective chart review of 68 neonates and their mothers who received methadone therapy during pregnancy. The last dosage of maternal methadone just before delivery and the length of treatment for neonatal abstinence syndrome were examined with an analysis of variance model.

      Results

      When the data were analyzed for methadone dosages as a continuous variable, each 1-mg increase in the last maternal methadone dosage before delivery was associated with an additional 0.18 days of infant treatment for neonatal abstinence syndrome (P < .001; 95% CI, 0.112-0.255). In other words, every increase of 5.5 mg of methadone in the mother was associated statistically with 1 additional day of neonatal abstinence syndrome treatment for the infant. Gestational age at delivery and birthweight were not statistically significant.

      Conclusion

      Higher doses of maternal methadone were associated with an increase in diagnosis and longer duration of neonatal abstinence syndrome.

      Key words

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        American Journal of Obstetrics & GynecologyVol. 201Issue 3
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          The article by Lim et al1 adds important data to the question of how maternal methadone dose affects both the rate of neonatal abstinence syndrome (NAS) and length of pharmacologic treatment for NAS. In 2007, Dysart et al2 noted that there were 19 studies, including 1951 neonates, on the relationship between maternal methadone dose and NAS, with the results equally divided for and against. Determining the true answer is difficult because of different methodologies that have been used.
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