Document Detail


Perinatal risk factors for the neonatal abstinence syndrome in infants born to women on methadone maintenance therapy.
MedLine Citation:
PMID:  20618243     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Neonatal abstinence syndrome (NAS) occurs in more than 50% of infants exposed to intrauterine opiates. Maternal opiate dosing has been investigated with conflicting results. AIMS: The aims of this study were to correlate maternal methadone dose and other risk factors with the development of NAS requiring pharmacological treatment by using easily accessible clinical parameters. METHODS: Retrospective medical record review of data from 228 opioid dependent pregnant women who delivered 232 live-born infants. Logistic regression analysis was performed on maternal, perinatal and neonatal parameters to identify risk factors for NAS requiring treatment. A prediction model was developed and validated on a separate independent cohort of 188 infants. RESULTS: Of the 232 infants, 172 (74%) infants were treated for NAS. The risk of withdrawal increased by 17% per 5 mg increment of the last maternal methadone dose. The risk was lower for younger gestational ages and for those delivered by Caesarean section compared to those delivered by normal vaginal delivery. Through predictive modeling, gestational age, mode of delivery and last methadone dose were established as risk factors for withdrawal. The model was validated by other statistical measures and its diagnostic performance confirmed on the separate independent cohort. CONCLUSIONS: Our data suggests that timing and mode of delivery as well as last maternal methadone dose are significant risk factors for the development of NAS requiring treatment. Based on these clinical parameters, risk stratification for perinatal management of pregnancies associated with opioid dependency and risk prediction for the neonate might now be possible.
Authors:
Anthony J W Liu; Michael P Jones; Henry Murray; Colleen-Maree Cook; Ralph Nanan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Australian & New Zealand journal of obstetrics & gynaecology     Volume:  50     ISSN:  1479-828X     ISO Abbreviation:  Aust N Z J Obstet Gynaecol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0001027     Medline TA:  Aust N Z J Obstet Gynaecol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  253-8     Citation Subset:  IM    
Affiliation:
Discipline of Paediatrics, Sydney Medical School - Nepean, The University of Sydney, Penrith, New South Wales, Australia. liua@wahs.nsw.gov.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Infant, Newborn
Logistic Models
Methadone / adverse effects*
Narcotics / adverse effects*
Neonatal Abstinence Syndrome / drug therapy,  epidemiology*
Opioid-Related Disorders / drug therapy*
Pregnancy
Pregnancy Complications / drug therapy*
Prenatal Exposure Delayed Effects / drug therapy,  epidemiology*
Retrospective Studies
Risk Assessment
Risk Factors
Young Adult
Chemical
Reg. No./Substance:
0/Narcotics; 76-99-3/Methadone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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