Neonatal outcome following methadone exposure in utero

Hagopian, George S.; Wolfe, Honor M.; Sokol, Robert J.; Ager, Joel W.; Wardell, James N.; Cepeda, Eugene

doi:10.1002/(sici)1520-6661(199611/12)5:6<348::aid-mfm11>3.3.co;2-w

Cited by 9 publications

(10 citation statements)

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“…Methadone has undoubtedly improved the management of pregnancy and neonatal outcome in heroin addicts [ 196 ]. For example, high methadone doses in the third trimester are related to improved fetal growth compared to pregnancies of non-treated heroin addicts [ 124 ]. Importantly, no serious fetal toxicity has been associated with methadone [ 81 , 222 ].…”

Section: Treatment For the Pregnant Heroin Usermentioning

confidence: 99%

The Effects of Maternally Administered Methadone, Buprenorphine and Naltrexone on Offspring: Review of Human and Animal Data

Farid¹,

Dunlop

Tait³

et al. 2008

139

144

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Most women using heroin are of reproductive age with major risks for their infants. We review clinical and experimental data on fetal, neonatal and postnatal complications associated with methadone, the current "gold standard", and compare these with more recent, but limited, data on developmental effects of buprenorphine, and naltrexone. Methadone is a -opioid receptor agonist and is commonly recommended for treatment of opioid dependence during pregnancy. However, it has undesired outcomes including neonatal abstinence syndrome (NAS). Animal studies also indicate detrimental effects on growth, behaviour, neuroanatomy and biochemistry, and increased perinatal mortality. Buprenorphine is a partial -opioid receptor agonist and a -opioid receptor antagonist. Clinical observations suggest that buprenorphine during pregnancy is similar to methadone on developmental measures but is potentially superior in reducing the incidence and prognosis of NAS. However, small animal studies demonstrate that low doses of buprenorphine during pregnancy and lactation lead to changes in offspring behaviour, neuroanatomy and biochemistry. Naltrexone is a non-selective opioid receptor antagonist. Although data are limited, humans treated with oral or sustained-release implantable naltrexone suggest outcomes potentially superior to those with methadone or buprenorphine. However, animal studies using oral or injectable naltrexone have shown developmental changes following exposure during pregnancy and lactation, raising concerns about its use in humans. Animal studies using chronic exposure, equivalent to clinical depot formulations, are required to evaluate safety. While each treatment is likely to have maternal advantages and disadvantages, studies are urgently required to determine which is optimal for offspring in the short and long term.

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Section: Treatment For the Pregnant Heroin Usermentioning

confidence: 99%

The Effects of Maternally Administered Methadone, Buprenorphine and Naltrexone on Offspring: Review of Human and Animal Data

Farid¹,

Dunlop

Tait³

et al. 2008

139

144

View full text Add to dashboard Cite

show abstract

“…Most pregnant women receiving MMT begin the therapy after conception, most commonly in the second or third trimester (Dashe et al, 1998;Hagopian et al, 1996). However, women who are already receiving MMT do conceive while on methadone and remain on methadone for the entire pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of neonates conceived on methadone maintenance therapy

McCarthy

Leamon

Stenson

et al. 2008

Journal of Substance Abuse Treatment

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“…Methadone, a synthetic opioid, has higher oral bioavailability than most opioids, long duration of action and less misuse potential 5. It is commonly prescribed as a substitute for illicit opioids such as heroin and is associated with a more stable maternal lifestyle as well as reduced incidence of both intrauterine growth restriction6 and preterm birth1 7 compared with non-treated heroin addicts. However, prescribed methadone is also associated with neonatal abstinence syndrome (NAS) in a majority of newborns, with symptoms severe enough to require pharmacological treatment in 45% to 80% of those 2 5…”

mentioning

confidence: 99%