Relationship between maternal methadone dosage and neonatal withdrawal

Dashe, Jodi S.; Sheffield, Jeanne S.; Olscher, Debora A.; Todd, Sally J.; Jackson, Gregory L.; Wendel, George D.

doi:10.1016/s0029-7844(02)02387-6

Cited by 113 publications

(67 citation statements)

References 15 publications

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“…(28–33) Methadone is usually initiated at 10–20 mg/day(34) and then titrated until the patient is asymptomatic in accordance with safe induction protocols (Table 1). (17, 35–43) Nearly half of women require a low daily dose (<60 mg), while the remainder are maintained initially on a medium (60–89 mg) or high dose (>90 mg).…”

Section: Medication-assisted Therapymentioning

confidence: 99%

Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes

Reddy¹,

Davis²,

Ren³

et al. 2017

Obstetrics &Amp; Gynecology

201

101

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In April 2016, the Eunice Kennedy Shriver National Institute of Child Health and Human Development invited experts to a workshop to address numerous knowledge gaps and to review the evidence for the screening and management of opioid use in pregnancy and neonatal abstinence syndrome. The rising prevalence of opioid use in pregnancy has led to a concomitant dramatic fivefold increase in neonatal abstinence syndrome over the past decade. Experts from diverse disciplines addressed research gaps in the following areas: 1) optimal screening for opioid use in pregnancy; 2) complications of pregnancy associated with opioid use; 3) appropriate treatments for pregnant women with opioid use disorders; 4) the best approaches for detecting, treating, and managing newborns with neonatal abstinence syndrome; and 5) the long-term effects of prenatal opioid exposure on children. Workshop participants identified key scientific opportunities to advance the understanding of opioid use disorders in pregnancy and to improve outcomes for affected women, their children, and their families. This article provides a summary of the workshop presentations and discussions.

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Section: Medication-assisted Therapymentioning

confidence: 99%

Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes

Reddy¹,

Davis²,

Ren³

et al. 2017

Obstetrics &Amp; Gynecology

201

101

View full text Add to dashboard Cite

show abstract

“…The symptoms include irritability, hyper-reflexia, hyperactivity, abnormal cry, diarrhoea, fever, vomiting, tachypnoea, convulsions or seizures, and coma. Maintenance doses of less than 20 mg/day during pregnancy convey a lower risk of neonatal abstinence syndrome, 16 but such doses are subtherapeutic and risk relapse to heroin use. However, at therapeutic doses, no relation exists between dose of methadone and risk of neonatal abstinence syndrome.…”

mentioning

confidence: 99%

Pregnancy and injecting drug use

Bell

Harvey-Dodds

2008

BMJ

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“…There are inconsistent data in the literature suggesting that there is a relation between the maternal dose of methadone and the severity of neonatal withdrawal. Some studies have shown that infants are more likely to have withdrawal symptoms with increasing maternal doses, [3][4][5] whereas others have shown no such relation. 6 7 Similarly, studies of neonatal methadone concentrations have shown a good correlation with maternal dose 4 8 or have shown no relation.…”

mentioning

confidence: 99%

Can methadone concentrations predict the severity of withdrawal in infants at risk of neonatal abstinence syndrome?

Kuschel

2004

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Aim: To assess the usefulness of cord and serum methadone concentrations at 2 days of age in predicting the severity of neonatal abstinence syndrome (NAS) in infants whose mothers received methadone during pregnancy. Methods: After informed consent, infants were enrolled if they were delivered at 35 weeks gestation or greater. Relevant information was collected from maternal notes. A sample of cord blood was taken at delivery, with a follow up sample at 48 hours of age. The samples were analysed in batches, and the results were unavailable to the attending clinical staff. Infants were treated for NAS on clinical grounds according to a standardised scoring system. Results: Twenty five of 36 eligible infants over the 21 month period of the study were enrolled. Of these, 12 required treatment for NAS. Maternal methadone dose did not predict the need for treatment. However, infants who required treatment had significantly lower methadone concentrations in cord blood than the group who did not receive treatment (31 v 88 ng/ml respectively; p = 0.029). Paired blood samples for methadone concentrations were available for 17 infants. All but one of the 12 infants who required treatment had undetectable concentrations of methadone in the postnatal sample, whereas the median postnatal methadone concentration in untreated infants was 23 ng/ml (p = 0.002). Conclusions: Methadone concentrations taken from cord blood may identify infants at greater risk of neonatal withdrawal and therefore requiring treatment.

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Relationship between maternal methadone dosage and neonatal withdrawal

Cited by 113 publications

References 15 publications

Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes

Opioid Use in Pregnancy, Neonatal Abstinence Syndrome, and Childhood Outcomes

Pregnancy and injecting drug use

Can methadone concentrations predict the severity of withdrawal in infants at risk of neonatal abstinence syndrome?

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