Abstract
Infants of 23 mothers on a methadone maintenance program were observed for evidence of drug withdrawal. Ten infants had no withdrawal; 13 had withdrawal symptoms and 9 required treatment. The mothers' highest methadone doses ranged from 7½-80 mg, and their lowest doses ranged from 0-40 mg. Mothers who in the third trimester had 1/3 or more of weekly random urines positive for heroin or who were suspected by the center of heroin use (e.g. refusal to have urine tested), were defined as heroin users.
In the 13 mothers not using heroin, only 3 infants (23%) had withdrawal symptoms. In the 10 mothers using heroin, all 10 infants had withdrawal symptoms. This difference is significant at p<.001.
When the mother's methadone dose at delivery was considered, the infants of 3 mothers who were on 15 mg or more of methadone and whose methadone dose had been increased before delivery, all exhibited withdrawal symptoms. In contrast, none of the infants of 10 mothers who were on <15 mg. methadone and had had no increase in dose before delivery showed withdrawal symptoms.
Conclusion: Mothers maintained on methadone during pregnancy had a greatly increased risk of delivering a symptomatic infant if they were also taking heroin during the third trimester, or if the methadone dosage had been increased prior to delivery.
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Sell, E., Bradley, N., Kale, K. et al. 268 INFLUENCE OF MATERNAL METHADONE AND HEROIN USE ON NEONATAL WITHDRAWAL. Pediatr Res 12 (Suppl 4), 408 (1978). https://doi.org/10.1203/00006450-197804001-00273
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DOI: https://doi.org/10.1203/00006450-197804001-00273