The Methadone-Maintained Pregnancy

Kandall, Stephen R.; Doberczak, Tatiana M.; Jantunen, Maria E.; Stein, Janet

doi:10.1016/s0095-5108(18)30077-0

Cited by 95 publications

(53 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Methadone maintenance treatment during pregnancy optimized obstetric care, decreased illicit drug use, and improved fetal outcomes. 28 Nevertheless, methadone treatment also has been related to the increased incidence of NAS. 12,29 Research on the pharmacokinetics of methadone during pregnancy has led to the administration of higher methadone doses than were used 20 years ago 30,31 ; however, it is unclear if these increases in maternal methadone dose have further increased the incidence of NAS.…”

Section: Growing Epidemiologymentioning

confidence: 99%

Neonatal Abstinence Syndrome

2014

View full text Add to dashboard Cite

Neonatal abstinence syndrome (NAS) is a result of the sudden discontinuation of fetal exposure to substances that were used or abused by the mother during pregnancy. Withdrawal from licit or illicit substances is becoming more common among neonates in both developed and developing countries. NAS continues to be an important clinical entity throughout much of the world. NAS leads to a constellation of signs and symptoms involving multiple systems. The pathophysiology of NAS is not completely understood. Urine or meconium confirmation may assist the diagnosis and management of NAS. The Finnegan scoring system is commonly used to assess the severity of NAS; scoring can be helpful for initiating, monitoring, and terminating treatment in neonates. Nonpharmacological care is the initial treatment option, and pharmacological treatment is required if an improvement is not observed after nonpharmacological measures or if the infant develops severe withdrawal. Morphine is the most commonly used drug in the treatment of NAS secondary to opioids. An algorithmic approach to the management of infants with NAS is suggested. Breastfeeding is not contraindicated in NAS, unless the mother is taking street drugs, is involved in polydrug abuse, or is infected with HIV. Future studies are required to assess the long-term effects of NAS on children after prenatal exposure.

show abstract

Section: Growing Epidemiologymentioning

confidence: 99%

Neonatal Abstinence Syndrome

2014

View full text Add to dashboard Cite

show abstract

“…Methadone treatment during pregnancy offers overwhelming advantages compared with the less acceptable option of medical detoxification or the unacceptably dangerous option of leaving heroinaddicted women dependent on street drugs (Kandall et al, 1999). The Maternal Opioid Treatment: Human Experimental Research (MOTHER) project found both methadone and buprenorphine to be important parts of a comprehensive treatment approach (Jones et al, 2012a(Jones et al, , 2012b.…”

Section: Human Studiesmentioning

confidence: 99%

Behavioral effects of perinatal opioid exposure

2014

View full text Add to dashboard Cite

“…The developmental and respiratory effects of in utero methadone exposure have been studied in infants of methadone maintenance patients [19,32]. However, these studies are often confounded by the use of alcohol, tobacco, cocaine, and/or illicit supplemental opioids; any one or combination of which can affect perinatal development [1,3,4,34].…”

Section: Introductionmentioning

confidence: 99%

Respiratory effects of chronic in utero methadone or morphine exposure in the neonatal guinea pig

Nettleton¹,

Wallisch²,

Olsen³

2008

Neurotoxicology and Teratology

View full text Add to dashboard Cite

This study uses a neonatal guinea pig model to compare the effects of in utero methadone or morphine exposure upon breathing control. We hypothesize that in utero methadone exposure will result in similar respiratory disturbances to those seen in morphine exposed neonates, but that the onset will be slower and the duration longer, due to methadone's longer elimination half-life. Pregnant DunkinHartley guinea pigs received once-daily injections of methadone, morphine, or vehicle (saline) during the last half of gestation and pups were studied 3, 7, or 14 days after birth. In utero methadone or morphine exposure resulted in decreased birth weight compared to vehicle, and pups experienced a withdrawal syndrome which included increased locomotor activity and respiratory disturbances but no change in rectal temperature. Both opioid exposures increased inspiratory minute ventilation during CO 2 challenge at 3 days after birth, but only in morphine exposed pups was this withdrawal effect still present on day 7. Surprisingly, only morphine exposure increased inspiratory minute ventilation during room air breathing. We conclude that in utero methadone exposure is not equivalent to in utero morphine exposure. With respect to neonatal respiratory control, methadoneinduced changes in respiration are only apparent during hypercapnia.

show abstract

The Methadone-Maintained Pregnancy

Cited by 95 publications

References 38 publications

Neonatal Abstinence Syndrome

Neonatal Abstinence Syndrome

Behavioral effects of perinatal opioid exposure

Respiratory effects of chronic in utero methadone or morphine exposure in the neonatal guinea pig

Contact Info

Product

Resources

About