American journal of perinatology · 2015
Maternal methadone treatment and neonatal abstinence syndrome.
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Liu William F, Singh Kultar, Faisal Mohamed, Li Shuang
Аннотация
OBJECTIVE: This article aims to describe neonatal outcomes, clinical correlates, and the rate for neonatal abstinence syndrome (NAS) for women on methadone maintenance therapy.
METHODS: This study is a retrospective review, which includes 119 mothers and 120 live newborns.
RESULTS: Methadone mothers tends to be white, single, on government insurance, with increased tobacco use (73%) and hepatitis C (11%). Prematurity increased (28%), and the term infant had a higher risk for admission for respiratory symptoms (22, 7%, p < 0.001). Overall, 78% newborns developed NAS, with the onset of symptoms 4.3 ± 2.9 days, and average length of stay of 36.7 ± 26.4 days. There was a decreased overall gestational age for those infants who did not have NAS (36, 38 weeks, p = 0.04). Overall, 56% had possible illicit drug supplementation. Self-reporting had a 59% negative predictive value with a positive drug screen. No difference in maternal methadone dosage and newborns with and without NAS. Increasing gestational age will increase the odds for NAS.
CONCLUSIONS: Newborns are at higher risk for prematurity and admission for respiratory symptoms. Utilizing a 7-day observation period, 78% of newborns were diagnosed with NAS with a mean onset of symptoms of 4.3 days. There was no difference in methadone dosage between babies with and without NAS. Increasing gestational age increases the risk for NAS.
METHODS: This study is a retrospective review, which includes 119 mothers and 120 live newborns.
RESULTS: Methadone mothers tends to be white, single, on government insurance, with increased tobacco use (73%) and hepatitis C (11%). Prematurity increased (28%), and the term infant had a higher risk for admission for respiratory symptoms (22, 7%, p < 0.001). Overall, 78% newborns developed NAS, with the onset of symptoms 4.3 ± 2.9 days, and average length of stay of 36.7 ± 26.4 days. There was a decreased overall gestational age for those infants who did not have NAS (36, 38 weeks, p = 0.04). Overall, 56% had possible illicit drug supplementation. Self-reporting had a 59% negative predictive value with a positive drug screen. No difference in maternal methadone dosage and newborns with and without NAS. Increasing gestational age will increase the odds for NAS.
CONCLUSIONS: Newborns are at higher risk for prematurity and admission for respiratory symptoms. Utilizing a 7-day observation period, 78% of newborns were diagnosed with NAS with a mean onset of symptoms of 4.3 days. There was no difference in methadone dosage between babies with and without NAS. Increasing gestational age increases the risk for NAS.