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Methadone Treatment During Pregnancy: Risks and Side Effects

written by: Rose Kivi • edited by: Emma Lloyd • updated: 9/19/2010

Methadone is prescribed to pregnant women addicted to heroin and other opiate narcotics as a safer alternative for the unborn baby. Possible effects of methadone treatment during pregnancy to the infant exist, but its use is generally considered safe and is thought to produce no long-term effects.

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    Why Methadone Treatment During Pregnancy

    Methadone treatment during pregnancy helps to prevent a mother addicted to heroin or other opioid drugs from experiencing withdrawal symptoms. When taken under a doctor's supervision, methadone is safer for the unborn child than other opiates. In fact, using methadone to prevent withdrawal symptoms can be beneficial to the unborn child, says the Substance Abuse and Mental Health Services Administration (SAMHSA), by preventing withdrawal symptoms that can cause uterine contractions, leading to a miscarriage or premature delivery.

    Although there are possible effects of methadone treatment during pregnancy to the infant, according to SAMHSA, infants exposed to methadone in-utero "do as well as other babies." Even with the potential risks of methadone treatment, infants exposed to methadone during pregnancy are healthier than infants exposed to heroin, says SAMHSA.

    Not all infants exposed to methadone during pregnancy experience harmful effects. The larger the doses of methadone the mother takes during pregnancy, the higher the chances of complications to the infant. During pregnancy, careful physician monitoring of the mother's methadone blood levels and methadone dosage adjustments when needed to reduce exposure to the unborn infant, reduces the chances of complications.

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    Premature Delivery Risk

    Methadone treatment during pregnancy can cause premature delivery. Through review of data, the researchers at the Department of Psychological Medicine, University of Auckland, New Zealand, found that the higher the dosages of methadone administered to the mother during pregnancy, the higher the risk of premature delivery. The researchers published the their findings in the article "Maternal Methadone Dose During Pregnancy and Infant Clinical Outcome", published in "Neurotoxicology and Teratology".

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    Lower Birth Size of Newborns

    Infants who were exposed to methadone as fetuses tend to weigh less at birth and have smaller head circumferences, compared to infants who were not exposed to methadone, says Dr. William Rayburn of the University of New Mexico in the report "Methadone Therapy During Pregnancy." As they age, methadone exposed infants usually catch up in growth and reach normal sizes.

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    Neonatal Abstinence Syndrome (NAS)

    Methadone exposure in-utero may cause the newborn to experience withdrawal symptoms after birth. Infant drug withdrawal is called neonatal abstinence syndrome, NAS for short. Methadone is a long-acting narcotic, which means that it stays in the system for a long time, which may cause a delay in infant withdrawal symptoms. While methadone withdrawal symptoms can occur sooner than 24 hours after birth, they may not begin until 5 to 10 days after birth, according to the University of Washington Academic Medical Center. Although, SAMHSA estimates that NAS symptoms can begin as late as four weeks after birth.

    Infant withdrawal symptoms from methadone may include sleeplessness, respiratory distress, fever, gastrointestinal upset, poor feeding and weight loss. Treatment for NAS is dependant on the severity of the withdrawal symptoms. Infants with minor symptoms may not require treatment, while infants with severe symptoms may be given pharmaceutical treatment and hospital observation.

    Not all infants exposed to methadone during pregnancy experience withdrawal symptoms. The larger the doses of methadone the mother takes during pregnancy, the higher the chances of NAS, says the University of Washington Academic Medical Center.

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    Disclaimer

    This article is for educational purposes only and is not meant to act as or replace medical advice. Methadone treatment may or may not be right for you and your child. Talk to your doctor about your options. Methadone treatment should only be taken under a doctor's supervision.

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    References

    Substance Abuse and Mental Health Services Administration (SAMHSA): Methadone Treatment for Pregnant Women: http://csat.samhsa.gov/publications/PDFs/PregnantWomen.pdf

    Neurotoxicology and Teratology; Maternal Methadone Dose During Pregnancy and Infant Clinical Outcome; Department of Psychological Medicine, University of Auckland, New Zealand; Wouldes TA, Woodward LJ; May-June 2010

    PROTOCOL #43 – Maternal Fetal Medicine, University of New Mexico; Methadone Therapy During Pregnancy; William Rayburn, MD; May 2009

    University of Washington Academic Medical Center; Neonatal Abstinence Syndrome (NAS), Clinical Presentation and Management; http://depts.washington.edu/nicuweb/NICU-WEB/nas.stm

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