Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Growth and developmental outcome of infants with in-utero exposure to methadone vs buprenorphine

Journal of Perinatology volume 35, pages 656–659 (2015)Cite this article

Subjects

Abstract

Objective:

To compare early growth and developmental outcome of infants with in-utero exposure to low-dose methadone (<100 mg per day), high-dose methadone (⩾100 mg per day) and buprenorphine.

Study Design:

A retrospective review of infants with in-utero methadone and buprenorphine exposure who were evaluated at the Southcoast Developmental Pediatric clinic in New Bedford, MA, USA was completed. Growth data and developmental testing results during infancy were compared among the groups.

Result:

Infants in the high-dose methadone group had lower head circumference z scores and a lower mean score on the Alberta Infant Motor Scale (AIMS). Regression results confirmed an association between methadone dose and head circumference z score and AIMS score.

Conclusion:

Exposure to maternal methadone dose in excess of 100 mg is associated with a reduction in infant head circumference when compared with buprenorphine or lower dose methadone, and may have a negative impact on motor skill development during early infancy.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Patrick SW, Schumacher RE, Benneyworth BD, Krans EE, McAllister JM, Davis MM . Neonatal abstinence syndrome and associated health care expenditures United States, 2000-2009. JAMA 2012; 307 (18): 1934–1940.

    Article  CAS  Google Scholar 

  2. Coyle MG Unpublished data from presentation, “Do newborns really care what drug their mother took?”, Neonatal Abstinence Syndrome Statewide Improvement Project, Neonatal Quality Improvement Collaborative of Massachusetts: Westborough, MA, 13/6/13.

  3. McCarthy JJ, Leamon MH, Parr MS, Anania B . High-dose methadone maintenance in pregnancy: maternal and neonatal outcomes. Am J Obstet Gynecol 2005; 193 (3Pt1): 606–610.

    Article  CAS  Google Scholar 

  4. Schindler SD, Eder H, Ortner R, Rhrmeister K, Langer M, Fischer G . Neonatal outcome following buprenorphine maintenance during conception and throughout pregnancy. Addiction 2003; 98 (1): 103–110.

    Article  Google Scholar 

  5. Jones HE, Kaltenbach K, Heil SH, Stine SM, Coyle MG, Arria AM, O’Grady KE, Selby P, Martin PR, Fischer G . Neonatal abstinence syndrome after methadone or buprenorphine exposure. N Engl J Med 2010; 363 (24): 2320–2331.

    Article  CAS  Google Scholar 

  6. Coyle MG, Salibury AL, Lester BM, Jones HE, Lin H, Graf-Rohrmeister K, Fischer G . Neonatal neurobehavior effects following buprenorphine versus methadone exposure. Addiction 2012; 107 (Suppl.1): 63–73.

    Article  Google Scholar 

  7. Brogly SB, Saia KA, Walley AY, Du HM, Sebastiani P . Prenatal buprenorphine versus methadone explosure and neonatal coutcomes: systematic review and meta-analysis. Am J Epidemiol 2014; 180 (7): 673–686.

    Article  Google Scholar 

  8. Finnegan LP, Kaltenbach K et al. Neonatal abstinence syndrome In: Hoekelman FA, Friedman SB, Nelson NM (eds). Primary Pediatric Care 2. Mosby: St Louis, MO, 1992; 1367–1378.

    Google Scholar 

  9. WHO Anthro for personal computers, version 3.2.2, 2011: Software for assessing growth and development of the world’s children. Geneva: WHO 2010, http://www.who.int/childgrowth/software/en/.

  10. Vohr BR, Garcia-Coll C . Neurodevelopmental and school performance of very low birth weight infants: a seven-year longitudinal study. Pediatrics 1985; 176: 345–350.

    Google Scholar 

  11. Bayley Scales of Infant Development. 2nd edn. Psychological Corporation: New York, NY, 1993.

  12. Piper MC, Darrah J . Motor Assessment of the Developing Infant. WB Saunders Company: Philadelphia, PA, 1994.

    Google Scholar 

  13. Shipton D, Mactier H, Dryden C, Tappin D . Substitute methadone prescribing in pregnancy is associated with impaired fetal head growth. Arch Dis Child Fetal Neonatal Ed 2011; 96: Fa45.

    Article  Google Scholar 

  14. Hytinantti T, Kahila H, Renlund M, Jarvenpaa A, Halmesmaki E, Kivitie-Kallio S . Neonatal outcome of 58 infants exposed to maternal buprenorphine in utero. Acta Paediatr 2008; 97: 1040–1044.

    Article  CAS  Google Scholar 

  15. Welle-Strand G, Skurtveit S, Jones H, Waal H, Bakstad B, Bjarkø L, Ravndal E . Neonatal outcomes following in utero exposure to methadone or buprenorphine: A National Cohort Study of opioid-agonist treatment of Pregnant Women in Norway from 1996 to 2009. Drug Alcohol Depend 2013; 127: 200–206.

    Article  CAS  Google Scholar 

  16. Lui A, Bjorkman T, Stewart C, Nanan R . Pharmacological treatment of neonatal opiate withdrawal: between the devil and the deep blue sea. Int J Pediatr 2011; 2011: 935631.1–935631.5.

    Google Scholar 

  17. Schrott LM, Franklin LM, Serrano PA . Prenatal opiate exposure impairs radial arm maze performance and reduces levels of BDNF precursor following training. Brain Res 2008; 1198: 132–140.

    Article  CAS  Google Scholar 

  18. McCarthy JJ, Leamon MH, Parr MS, Anania B . High-dose methadone maintenance in pregnancy: maternal and neonatal outcomes. Am J Obst Gyn 2005; 193 (3Pt1): 606–610.

    Article  CAS  Google Scholar 

  19. Wilson GS, Desmond MM, Wlit RB . Follow-up of methadone-treated women and their infants: Health, development, and social implications. J Pediatr 1981; 98: 716–722.

    Article  CAS  Google Scholar 

  20. Kronstadt D . Complex developmental issues of prenatal drug exposure. Drug Exposed Infants 1 (1) 1991.

  21. Kaltenbach K, Finnegan L . Developmental outcome of children born to methadone maintained women: a review of longitudinal studies. Neurobehav Toxicol Teratol 1984; 6: 271–275.

    CAS  PubMed  Google Scholar 

  22. McGlone L, Mactier H, Hamilton R, Bradnam MS, Boulton RG, Borland W, Hepburn M, McCulloch DL . Visual evoked potentials in infants exposed to methadone in utero. Arch Dis Child 2008; 93 (9): 784–786.

    Article  CAS  Google Scholar 

  23. Oberlander TF, Misri S, Fitzgerald CE, Kostaras X, Rurak D, Riggs W . Pharmacologic factors associated with transient neonatal symptoms following prenatal psychotropic medication exposure. J Clin Psychiatry 2004; 65: 230–237.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of General Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    J B Bier

  2. Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    A S Finger

  3. Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    B A Bier

  4. Department of Physical Medicine, St Luke’s Hospital, New Bedford, MA, USA

    T A Johnson & M G Coyle

  5. Department of Pediatrics, Women & Infants’ Hospital, Warren Alpert Medical School of Brown University, Providence, RI, USA

    M G Coyle

Authors
  1. J B Bier
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A S Finger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B A Bier
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T A Johnson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M G Coyle
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J B Bier.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bier, J., Finger, A., Bier, B. et al. Growth and developmental outcome of infants with in-utero exposure to methadone vs buprenorphine. J Perinatol 35, 656–659 (2015). https://doi.org/10.1038/jp.2015.22

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2015.22

This article is cited by

Search

Advanced search

Quick links