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Effects of polysubstance exposure on neonatal outcomes for infants with intrauterine opioid exposure

Journal of Perinatology volume 40, pages 1489–1496 (2020)Cite this article

Subjects

Abstract

Objective

Quantify the effect of prenatal polysubstance exposure on neonatal outcomes compared to methadone exposure alone.

Study design

This retrospective cohort study compared infants with methadone-only exposure to methadone with additional psychoactive substances. Outcomes included time to maximum Finnegan scores, proportion requiring scheduled morphine, and length of stay (LOS).

Results

We identified 323 subjects. The median time to maximum Finnegan score was 38.0 h with 94% peaking within 96 h. Forty-five percent of methadone-only infants were started on scheduled morphine compared to 54% of polysubstance infants (p = 0.10). LOS for polysubstance-exposed infants was 1.30 times longer than infants with methadone-only exposure (95% confidence interval: 1.05, 1.60).

Conclusions

Exposure to methadone with additional psychoactive substances is associated with longer LOS, but not postnatal morphine use or peak withdrawal symptoms. Most infants experience peak withdrawal symptoms within 4 days and may not benefit from longer observation.

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Fig. 1: Time to Maximum Finnegan Score.

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Funding

This study is supported by the Center for Clinical and Translational Research, Seattle Children’s Hospital. The funder played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the paper.

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Washington, Seattle, WA, USA

    Corrie E. McDaniel, Matthew Test, Parimal Deodhar & Rebecca Jennings

  2. Division of Women and Children’s, Providence St. Joseph’s Health System, Renton, WA, USA

    Corrie E. McDaniel, Matthew Test & Parimal Deodhar

  3. Department of Internal Medicine, Providence St. Vincent Hospital, Portland, OR, USA

    Joanna Bove

  4. Seattle Children’s Research Institute, Seattle, WA, USA

    Kristen Carlin

Authors
  1. Corrie E. McDaniel
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Contributions

CEM contributed to the conception of the study, the acquisition, analysis, and interpretation of data, and the writing and revising of the paper. She has approved the final version. MT and PD contributed to the acquisition and interpretation of data and the writing and revising of the paper. They have approved the final version. JB contributed to the conception of the study and the acquisition of the data, and the writing and revising of the paper. She has approved the final version. RJ and KC contributed to the conception of the study, the analysis and interpretation of data, and the writing and revising of the paper. They have approved the final version.

Corresponding author

Correspondence to Corrie E. McDaniel.

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McDaniel, C.E., Test, M., Deodhar, P. et al. Effects of polysubstance exposure on neonatal outcomes for infants with intrauterine opioid exposure. J Perinatol 40, 1489–1496 (2020). https://doi.org/10.1038/s41372-020-0717-y

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