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AIM: To determine if there is a relationship between maternal methadone dose in pregnancy and the diagnosis or medical treatment of neonatal abstinence syndrome (NAS). METHODS: PubMed, EMBASE, the Cochrane Library and PsychINFO were searched for studies reporting on methadone use in pregnancy and NAS (1966-2009). The relative risk (RR) of NAS was compared for methadone doses above versus below a range of cut-off points. Summary RRs and 95% confidence intervals (CI) were estimated using random effects meta-analysis. Sensitivity analyses explored the impact of limiting meta-analyses to prospective studies or studies using an objective scoring system to diagnose NAS. RESULTS: A total of 67 studies met inclusion criteria for the systematic review; 29 were included in the meta-analysis. Any differences in the incidence of NAS in infants of women on higher compared with lower doses were statistically non-significant in analyses restricted to prospective studies or to those using an objective scoring system to diagnose NAS. CONCLUSIONS: Severity of the neonatal abstinence syndrome does not appear to differ according to whether mothers are on high- or low-dose methadone maintenance therapy.

Original publication

DOI

10.1111/j.1360-0443.2010.03120.x

Type

Journal article

Journal

Addiction

Publication Date

12/2010

Volume

105

Pages

2071 - 2084

Keywords

Cohort Studies, Databases, Bibliographic, Dose-Response Relationship, Drug, Female, Humans, Infant, Newborn, Methadone, Narcotics, Neonatal Abstinence Syndrome, Opioid-Related Disorders, Pregnancy, Pregnancy Complications, Prenatal Exposure Delayed Effects, Randomized Controlled Trials as Topic, Severity of Illness Index