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Objective: Prior studies noted elevated preterm birth (PTB) rates among opiate-addicted women treated with methadone. We sought to determine the risk factors for PTB in this population. Study Design: We performed a retrospective cohort study of opiate-addicted gravid women treated with methadone who delivered a single neonate between 2000 and 2006. Variables evaluated as potential risk factors for PTB less than 37 weeks included medical and infectious comorbidities and “supplements to methadone” (illicit drugs and/or alcohol). Results: The overall PTB rate was 29.1% (75/258). No medical or infectious comorbidity was predictive of PTB. Among women abusing 0, 1, 2, or 3 or more supplements in addition to methadone, the PTB rate was 24.2% (reference), 25.5% (P = .50), 47.6% (P = .04), and 64.7% (P = .01), respectively. Conclusion: The PTB rate among women on methadone (29.1%) is nearly 3 times the national average (11.1%), and those abusing 2 or more supplements to methadone are at further increased risk for PTB. [Copyright &y& Elsevier]

Objective: The objective of the study was to identify maternal variables predicting length of treatment for neonatal abstinence syndrome (NAS). Study Design: This was a retrospective cohort study of infants treated for NAS during 2000-2006 whose mothers were on methadone maintenance at delivery. Mixed-effects linear regression was used to examine the interaction of maternal and neonatal variables with length of treatment. Results: Of 204 neonates born to methadone exposed mothers, the average dose at delivery was 127 mg daily (25-340 mg) with median length of treatment 32 days (1-122 days). Trimester of initial exposure (P = .33), methadone dose at delivery (P = .198), body mass index (P = .31), antidepressant use (P = .40), cigarette use (P = .76), race (P = .78), and maternal age (P = .84) did not predict length of treatment. In the multivariate analysis, gestational age at delivery and benzodiazepine use were significant predictors of length of treatment. Conclusion: Later gestational age and concomitant benzodiazepine use were associated with longer treatment. [Copyright &y& Elsevier]