Methadone maintenance in pregnancy: A reappraisal

Byline: Haywood L. Brown, Kathy A. Britton, Danielle Mahaffey, Edward Brizendine, A.Kinney Hiett, Mureena A. Turnquest Keywords: Methadone; illicit drug use; neonatal outcome Abstract: OBJECTIVE: The purpose of this study is to evaluate women receiving methadone maintenance during pregnancy. STUDY DESIGN: Thirty-two pregnancies in women receiving methadone maintenance were matched by gestational age to women with a positive urine screen for cocaine at delivery and to drug-free controls. Pregnancy outcome variables were compared, including birth weight and neonatal morbidity. Analysis was by I.sup.2 and t test with significance set at .05. RESULTS: Birth weight of methadone-exposed infants was 2748 g versus 2925 g for cocaine and 3032 g for controls, P = not significant. Birth weight comparison with a 50-mg maternal methadone cutoff dose was not different. A head circumference for methadone infants of 32.4 [+ or -] 4.7 cm was significantly less than controls, 33.5 [+ or -] 4.0 cm, P < .04, but not different from infants of cocaine users, 32.8 [+ or -] 3.1 cm. Women using cocaine had a significantly higher incidence of meconium in labor compared with methadone and controls. Of women taking methadone 27 of 32 (84.3%) were positive for other drugs of abuse in the last screen before or at delivery. Cocaine 12 of 32 (37.5%), other opiates 13 of 32 (40.6%), and marijuana 14 of 32 (43.7%) were the most prevalent. Neonatal withdrawal occurred in 23 of 32 (72%) women taking methadone. The neonates of women using CONCLUSIONS: Birth outcome is not significantly different between methadone and cocaine users. Women receiving methadone maintenance are likely to abuse other illicit drugs. (Am J Obstet Gynecol 1998;179:459-63.) Author Affiliation: Indianapolis, Indiana Article History: Received 22 April 1997; Revised 25 November 1997; Accepted 15 January 1998 Article Note: (footnote) [star] From the Department of Obstetrics and Gynecology,a and the Division of Biostatistics,b Indiana University Medical Center., [star][star] Reprint requests: Haywood L. Brown, MD, Department of Obstetrics and Gynecology, Wishard Memorial Hospital F-5, 1001 West 10th St, Indianapolis, IN 46202., a 0002-9378/98 $5.00 + 0 6/1/89109