Methadone dose and neonatal abstinence syndrome-systematic review and meta-analysis.
AuthorsCleary, Brian J
Gallagher, Paul J
Murphy, Deirdre J
AffiliationCoombe Women and Infants University Hospital, Dublin 8, Ireland School of, Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland., firstname.lastname@example.org
Dose-Response Relationship, Drug
Methadone/*administration & dosage/adverse effects
Narcotics/*administration & dosage/adverse effects
Neonatal Abstinence Syndrome/*epidemiology/etiology
Opioid-Related Disorders/*drug therapy
Pregnancy Complications/*drug therapy
Prenatal Exposure Delayed Effects
Randomized Controlled Trials as Topic
Severity of Illness Index
MetadataShow full item record
CitationAddiction. 2010 Dec;105(12):2071-84. doi: 10.1111/j.1360-0443.2010.03120.x. Epub , 2010 Sep 15.
JournalAddiction (Abingdon, England)
AbstractAIM: 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.