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Am J Perinatol 2015; 32(11): 1078-1086
DOI: 10.1055/s-0035-1549218
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Maternal Methadone Treatment and Neonatal Abstinence Syndrome

William F. Liu
1   Division of Neonatology, Golisano Children's Hospital of Southwest Florida, Fort Myers, Florida
2   Pediatrix Medical Group of Florida, Fort Myers, Florida
,
Kultar Singh
1   Division of Neonatology, Golisano Children's Hospital of Southwest Florida, Fort Myers, Florida
2   Pediatrix Medical Group of Florida, Fort Myers, Florida
,
Mohamed Faisal
1   Division of Neonatology, Golisano Children's Hospital of Southwest Florida, Fort Myers, Florida
2   Pediatrix Medical Group of Florida, Fort Myers, Florida
,
Shuang Li
3   Department of Mathematics, Florida Gulf Coast University, Fort Myers, Florida
› Author Affiliations
Further Information

Publication History

20 December 2014

12 February 2015

Publication Date:
27 April 2015 (online)

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Abstract

Objective This article aims to describe neonatal outcomes, clinical correlates, and the rate for neonatal abstinence syndrome (NAS) for women on methadone maintenance therapy.

Methods This study is a retrospective review, which includes 119 mothers and 120 live newborns.

Results Methadone mothers tends to be white, single, on government insurance, with increased tobacco use (73%) and hepatitis C (11%). Prematurity increased (28%), and the term infant had a higher risk for admission for respiratory symptoms (22, 7%, p < 0.001). Overall, 78% newborns developed NAS, with the onset of symptoms 4.3 ± 2.9 days, and average length of stay of 36.7 ± 26.4 days. There was a decreased overall gestational age for those infants who did not have NAS (36, 38 weeks, p = 0.04). Overall, 56% had possible illicit drug supplementation. Self-reporting had a 59% negative predictive value with a positive drug screen. No difference in maternal methadone dosage and newborns with and without NAS. Increasing gestational age will increase the odds for NAS.

Conclusions Newborns are at higher risk for prematurity and admission for respiratory symptoms. Utilizing a 7-day observation period, 78% of newborns were diagnosed with NAS with a mean onset of symptoms of 4.3 days. There was no difference in methadone dosage between babies with and without NAS. Increasing gestational age increases the risk for NAS.

Keywords

neonatal drug withdrawal - neonatal opiate withdrawal - methadone maintenance therapy - opioid