Document Detail


Prenatal methadone exposure, meconium biomarker concentrations and neonatal abstinence syndrome.
MedLine Citation:
PMID:  20854338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Methadone is standard pharmacotherapy for opioid-dependent pregnant women, yet the relationship between maternal methadone dose and neonatal abstinence syndrome (NAS) severity is still unclear. This research evaluated whether quantification of fetal methadone and drug exposure via meconium would reflect maternal dose and predict neonatal outcomes.
DESIGN: Prospective clinical study.
SETTING: An urban drug treatment facility treating pregnant and post-partum women and their children.
PARTICIPANTS: Forty-nine opioid-dependent pregnant women received 30-110 mg methadone daily.
MEASUREMENTS: Maternal methadone dose, infant birth parameters and NAS assessments were extracted from medical records. Thrice-weekly urine specimens were screened for opioids and cocaine. Newborn meconium specimens were quantified for methadone, opioid, cocaine and tobacco biomarkers.
FINDINGS: There was no relationship between meconium methadone concentrations, presence of opioids, cocaine and/or tobacco in meconium, maternal methadone dose or NAS severity. Opioid and cocaine were also found in 36.7 and 38.8 of meconium specimens, respectively, and were associated with positive urine specimens in the third trimester. The presence of opioids other than methadone in meconium correlated with increased rates of preterm birth, longer infant hospital stays and decreased maternal time in drug treatment.
CONCLUSIONS: Methadone and its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) concentrations in meconium did not predict infant birth parameters or NAS severity. Prospective urine testing defined meconium drug detection windows for opiates and cocaine as 3 months, rather than the currently accepted 6 months. The presence of opioids in meconium could be used as a biomarker for infants at elevated risk in the newborn period.
Authors:
Teresa R Gray; Robin E Choo; Marta Concheiro; Erica Williams; Andrea Elko; Lauren M Jansson; Hendreé E Jones; Marilyn A Huestis
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural     Date:  2010-09-20
Journal Detail:
Title:  Addiction (Abingdon, England)     Volume:  105     ISSN:  1360-0443     ISO Abbreviation:  Addiction     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-08     Completed Date:  2011-04-28     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  9304118     Medline TA:  Addiction     Country:  England    
Other Details:
Languages:  eng     Pagination:  2151-9     Citation Subset:  IM    
Copyright Information:
© 2010 Society for the Study of Addiction. No claim to original US government works.
Affiliation:
Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD 21224, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesics, Opioid / adverse effects,  analysis
Cocaine / adverse effects,  analysis
Cocaine-Related Disorders / drug therapy,  urine
Female
Gestational Age
Humans
Infant, Newborn
Length of Stay
Meconium / chemistry*
Methadone / administration & dosage,  adverse effects,  analysis*
Narcotics / administration & dosage,  adverse effects,  analysis*
Neonatal Abstinence Syndrome / epidemiology*
Opiate Substitution Treatment
Opioid-Related Disorders / drug therapy*,  urine
Predictive Value of Tests
Pregnancy
Pregnancy Complications / drug therapy*
Premature Birth / epidemiology
Prenatal Exposure Delayed Effects / epidemiology
Prospective Studies
Substance Abuse Detection / methods*
Young Adult
Grant Support
ID/Acronym/Agency:
DA019934/DA/NIDA NIH HHS; DA12403/DA/NIDA NIH HHS; Z01 DA000412-10/DA/NIDA NIH HHS; ZIA DA000433-10/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Narcotics; 50-36-2/Cocaine; 76-99-3/Methadone
Comments/Corrections

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