Methadone‐exposed newborn infants: outcome after alterations to a service for mothers and infants

Miles, J.F.; Sugumar, Kiruthiga; Macrory, F.; Sims, D G; D'Souza, S W

doi:10.1111/j.1365-2214.2006.00635.x

Cited by 16 publications

(11 citation statements)

References 28 publications

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“…49,54,62,64 Of the infants prenatally exposed to methadone and/or heroin described by Harper et al, 49 congenital malformations were observed in 3 (ie, diaphragmatic hernia, bifid thoracic vertebrae, and polydactyly). Kivistö et al 54 observed malformations in 10 out of 102 infants (ie, pulmonary artery stenosis; VSDs; primary vesicoureteral reflux grade III; primary vesicoureteral reflux grade III–IV with hydronephrosis; duplex thumb with left-sided duplex urinary collecting system; palatal cleft with ankyloglossia; Pierre Robin syndrome with undescended testicle; microtia with stenotic external ear canal; tetralogy of Fallot with bilateral inguinal hernias, multiple skeletal anomalies, and thymic aplasia; and mild hypospadias) prenatally exposed to buprenorphine.…”

Section: Resultsmentioning

confidence: 97%

“…37,38,44,49,54,62,64 Three of the 7 studies described congenital malformations collectively. 37,38,44 Blumenthal et al 38 reported a higher prevalence of congenital malformations in the heroin-exposed group (12.7 per 1000 live births) than among all live births in New York City (10 per 1000 live births).…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 5 infants had a major anomaly with functional or cosmetic significance, which was reported to be slightly higher than what is observed on average in the general population (3.4%). Miles et al 62 reported 2 cases of cleft palate among infants exposed to methadone during pregnancy (either alone or in combination with illicit substances). Lastly, Newman 64 reported malformations in 7 infants exposed to methadone (ie, heart murmurs [not generally considered a congenital malformation], hernia, bilateral foot deformity, imperforate anus, and esophageal defect).…”

Section: Resultsmentioning

confidence: 99%

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Maternal Use of Opioids During Pregnancy and Congenital Malformations: A Systematic Review

et al. 2017

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CONTEXT Opioid use and abuse have increased dramatically in recent years, particularly among women. OBJECTIVES We conducted a systematic review to evaluate the association between prenatal opioid use and congenital malformations. DATA SOURCES We searched Medline and Embase for studies published from 1946 to 2016 and reviewed reference lists to identify additional relevant studies. STUDY SELECTION We included studies that were full-text journal articles and reported the results of original epidemiologic research on prenatal opioid exposure and congenital malformations. We assessed study eligibility in multiple phases using a standardized, duplicate review process. DATA EXTRACTION Data on study characteristics, opioid exposure, timing of exposure during pregnancy, congenital malformations (collectively or as individual subtypes), length of follow-up, and main findings were extracted from eligible studies. RESULTS Of the 68 studies that met our inclusion criteria, 46 had an unexposed comparison group; of those, 30 performed statistical tests to measure associations between maternal opioid use during pregnancy and congenital malformations. Seventeen of these (10 of 12 case-control and 7 of 18 cohort studies) documented statistically significant positive associations. Among the case-control studies, associations with oral clefts and ventricular septal defects/atrial septal defects were the most frequently reported specific malformations. Among the cohort studies, clubfoot was the most frequently reported specific malformation. LIMITATIONS Variabilities in study design, poor study quality, and weaknesses with outcome and exposure measurement. CONCLUSIONS Uncertainty remains regarding the teratogenicity of opioids; a careful assessment of risks and benefits is warranted when considering opioid treatment for women of reproductive age.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Maternal Use of Opioids During Pregnancy and Congenital Malformations: A Systematic Review

et al. 2017

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“…Furthermore, costs associated with caring for NAS infants with long hospital stays are extensive. 15,16 From 2004 to 2008, Nationwide Children's Hospital (NCH) in Columbus, Ohio, experienced a sixfold increase in infants with NAS. These infants were exposed in utero to maternal opioid, in particular methadone, heroin, and/or hydrocodone.…”

Section: Discussionmentioning

confidence: 99%

A Quality Improvement Project to Reduce Length of Stay for Neonatal Abstinence Syndrome

Asti¹,

Magers²,

Keels³

et al. 2015

PEDIATRICS

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BACKGROUND AND OBJECTIVE: Neonatal abstinence syndrome (NAS), a self-limiting condition, is associated with clinical symptoms that may require pharmacological intervention. Optimal treatment of NAS remains undetermined, but the hospital length of stay (LOS) for patients with NAS is partially dependent upon a standard treatment protocol used. Prolonged LOS for patients with NAS can lead to adverse patient harm, impaired maternal-infant attachment, and significant health care costs. Therefore, we conducted a quality improvement study to reduce the LOS for infants with NAS. METHODS:In 2009, a multidisciplinary NAS Taskforce was created to implement a standardized treatment protocol, discuss the strengths and weaknesses of the current medical and nursing management, and improve communication among staff. Infants with NAS that required pharmacological intervention were followed throughout their hospitalization. Readmission within 30 days of hospital discharge was tracked as a balancing measure. On average, 10.7% of nonpregnant women of childbearing age and 5.9% of pregnant women reported illicit drug use in the month before the survey.

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“…50 Misuse of benzodiazepines with methadone or heroin is common. 50 Misuse of benzodiazepines with methadone or heroin is common.…”

Section: Benzodiazepinesmentioning

confidence: 99%

Substance Misuse During Pregnancy: Its Effects and Treatment

Moran

Madgula

Gilvarry

et al. 2009

Fet. Matern. Med. Rev.

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Prenatal care reduces the impact of illicit drug use on perinatal outcomes. Women who misuse substances are often excluded from mainstream society and, on becoming pregnant, feel guilty about their drug misuse and the potential effects this could have on their unborn baby. These women are vulnerable in many ways and agencies must ensure that they are not excluded from antenatal care. The latest enquiry into maternal deaths published in the UK (CEMACH report) highlights how women with socially complex lives who died were far less likely to have sought antenatal care early in pregnancy or to remain in regular contact with maternity services. Of the women who died from any cause, 11% had problems with substance abuse of whom 60% were registered addicts. Gaps in communication between agencies was highlighted as a particular problem.

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Methadone‐exposed newborn infants: outcome after alterations to a service for mothers and infants

Cited by 16 publications

References 28 publications

Maternal Use of Opioids During Pregnancy and Congenital Malformations: A Systematic Review

Maternal Use of Opioids During Pregnancy and Congenital Malformations: A Systematic Review

A Quality Improvement Project to Reduce Length of Stay for Neonatal Abstinence Syndrome

Substance Misuse During Pregnancy: Its Effects and Treatment

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