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Methadone dose and neonatal abstinence syndrome—systematic review and meta‐analysis
Author(s) -
Cleary Brian J.,
Donnelly Jean,
Strawbridge Judith,
Gallagher Paul J.,
Fahey Tom,
Clarke Mike,
Murphy Deirdre J.
Publication year - 2010
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/j.1360-0443.2010.03120.x
Subject(s) - methadone , medicine , meta analysis , confidence interval , cochrane library , prospective cohort study , abstinence , relative risk , pregnancy , methadone maintenance , incidence (geometry) , medline , pediatrics , obstetrics , psychiatry , physics , biology , political science , law , optics , genetics
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.