Objective To examine opioid replacement therapy in pregnancy and maternal effects on neonatal outcomes including length of hospital stay for neonatal abstinence syndrome. Design Retrospective descriptive study. Setting Labor and Delivery Unit and Neonatal Intensive Care Unit (NICU), Eastern Maine Medical Center, Bangor, Maine. Participants One hundred fifty two opioid dependent pregnant women on methadone maintenance therapy (MMT) (n = 136) or buprenorphine maintenance therapy (BMT) (n =16) during pregnancy and their neonates. The neonates were born between January 1, 2005 and December 31, 2007. Methods A review of the electronic medical records (EMR) was conducted of all opioid dependent women who were maintained on MMT or BMT at the time of admission for labor and delivery and their neonates. Results Maternal methadone dose and concomitant in-utero exposure to benzodiazepines prolonged the length of hospital stay for neonates. Length of stay was shorter in breastfed neonates as compared to formula fed neonates or neonates who received formula and breast milk. Neonates with a prenatal exposure to MMT as compared to BMT spent more days in the hospital (21 vs. 14 days) for treatment of neonatal abstinence syndrome (NAS). Conclusion These findings are consistent with previous research on the simultaneous use of methadone and benzodiazepines during pregnancy and provide further direction for the treatment of opioid dependency during pregnancy. Harm reduction strategies for opioid dependent pregnant women in substance abuse treatment with MMT may one day include guidance on daily treatment doses and recommendations to avoid the concomitant use of benzodiazepines to lessen NAS. Breastfeeding should be recommended to shorten LOS. Understanding perinatal and neonatal outcomes of pregnant women on methadone or buprenorphine will help to identify optimal treatment for opioid dependency in pregnancy.

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A convenience sample of 40 native-born pregnant Korean women receiving prenatal care at a U.S. military facility in a major metropolitan area in Korea completed a questionnaire about attitudes toward pregnancy and prenatal care. Responses revealed a family life characterized by positive maternal and paternal perceptions of the pregnancy and less preference for a male child than we had anticipated. Traditional beliefs in Tae Mong, a conception dream, and Tae Kyo, rituals for safe childbirth, were followed. Food taboos, including protein sources, were reported. Attitudes toward prenatal care services, care providers, and maternal health habits are described.

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