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Methadone dosing and prescribed medication use in a prospective cohort of opioid‐dependent pregnant women
Author(s) -
Cleary Brian J.,
Reynolds Kieran,
Eogan Maeve,
O'Connell Michael P.,
Fahey Tom,
Gallagher Paul J.,
Clarke Tom,
White Martin J.,
McDermott Christine,
O'Sullivan Anne,
Carmody Deirdre,
Gleeson Justin,
Murphy Deirdre J.
Publication year - 2013
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12078
Subject(s) - medicine , methadone , dosing , pregnancy , prospective cohort study , incidence (geometry) , opioid use disorder , cohort , obstetrics , opioid , medical record , anesthesia , genetics , physics , receptor , optics , biology
Aims This study aimed to (i) describe methadone dosing before, during and after pregnancy, (ii) to compare the incidence of neonatal abstinence syndrome ( NAS ) between those with dose decreases and those with steady or increasing doses and (iii) to describe prescribed medication use among opioid‐dependent pregnant women. Design Prospective cohort study. Setting Two I rish tertiary care maternity hospitals. Participants A total of 117 pregnant women on methadone maintenance treatment ( MMT ) recruited between J uly 2009 and J uly 2010. Measurements Electronic dispensing records from addiction clinics and the P rimary C are R eimbursement S ervice were used to determine methadone doses and dispensed medications in the year preceding and the month following delivery. The F innegan score was used to determine need for medical treatment of NAS . Findings Of the 117 participants, sufficient dosing data were available for 89 women treated with MMT throughout pregnancy; 36 (40.4%) had their dose decreased from a mean pre‐pregnancy dose of 73.3 mg [standard deviation (SD) 25.5] to a third‐trimester dose of 58.0 mg ( SD 26.0). The corresponding figures for those with increased doses ( n = 31, 34.8%) were 70.7 mg ( SD 25.3) and 89.7 mg ( SD 21.0), respectively. The incidence of medically treated NAS did not differ between dosage groups. Antidepressants were dispensed for 29 women (25.7%) during pregnancy, with the rate decreasing from pre‐pregnancy to postpartum. Benzodiazepines were prescribed for 43 women (38.0%). Conclusion In the I rish health service, opioid‐dependent women frequently have their methadone dose decreased during pregnancy but this does not appear to affect the incidence of the neonatal abstinence syndrome in their babies.