Can methadone concentrations predict the severity of withdrawal in infants at risk of neonatal abstinence syndrome?

Kuschel, C. A.; Austerberry, L.; Cornwell, M.; Couch, R.; Rowley, R. S. H.
September 2004
Archives of Disease in Childhood -- Fetal & Neonatal Edition;Sep2004, Vol. 89 Issue 5, pF390
Academic Journal
Aim: To assess the usefulness of cord and serum methadone concentrations at 2 days of age in predicting the severity of neonatal abstinence syndrome (NAS) in infants whose mothers received methadone during pregnancy. Methods: After informed consent, infants were enrolled if they were delivered at 35 weeks gestation or greater. Relevant information was collected from maternal notes. A sample of cord blood was taken at delivery, with a follow up sample at 48 hours of age. The samples were analysed in batches, and the results were unavailable to the attending clinical staff. Infants were treated for NAS on clinical grounds according to a standardised scoring system. Results: Twenty five of 36 eligible infants over the 21 month period of the study were enrolled. Of these, 12 required treatment for NAS. Maternal methadone dose did not predict the need for treatment. However, infants who required treatment had significantly lower methadone concentrations in cord blood than the group who did not receive treatment (31 v 88 ng/ml respectively; p = 0.029). Paired blood samples for methadone concentrations were available for 17 infants. All but one of the 12 infants who required treatment had undetectable concentrations of methadone in the postnatal sample, whereas the median postnatal methadone concentration in untreated infants was 23 ng/ml (p = 0.002). Conclusions: Methadone concentrations taken from cord blood may identify infants at greater risk of neonatal withdrawal and therefore requiring treatment.


Related Articles

  • Court-Ordered Care � A Complication of Pregnancy to Avoid. Cantor, Julie D. // New England Journal of Medicine;6/14/2012, Vol. 366 Issue 24, p2237 

    The article focuses on U.S. court-ordered care for pregnant women refusing to consent to medical treatment. It relates the case of expectant mother Samantha Burton of Florida who was ordered by a court to comply when she refused the prescribed continuous bed rest after her membranes ruptured....

  • True North. Farrell, Ruth M. // Hastings Center Report;Mar2009, Vol. 39 Issue 2, p9 

    The article discusses the experience of the author as an obstetrician and bioethicist in helping a couple decide about ex utero intrapartum treatment (EXIT). The couple were told that their baby had arthrogyrosis, a genetic condition in which in which the joints of the body become permanently...

  • HIV sero-prevalance in general population of Warangal, A.P., South India. Radhakrishna, Muttineni; Reddy, M. Krishna; Krishna, D. R. // Journal of Environmental Biology;Oct2007, Vol. 28 Issue 4, p865 

    HIV / AIDS pandemic has devastated many countries reversing national development; HIV was not seen in Asia and India till 1980. Now India has become epicenter of AIDS pandemic. During April 2002 to March 2003 the HIV + ve pregnant women and their husbands were encouraged to enroll in the...

  • Tobacco Use and Secondhand Smoke Exposure During Pregnancy: An Investigative Survey of Women in 9 Developing Nations. Bloch, Michele; Althabe, Fernando; Onyamboko, Marie; Kaseba-Sata, Christine; Castilla, Eduardo E.; Freire, Salvio; Garces, Ana L.; Parida, Sailajanandan; Goudar, Shivaprasad S.; Kadir, Muhammad Masood; Goco, Norman; Thornberry, Jutta; Daniels, Magdalena; Bartz, Janet; Hartwell, Tyler; Moss, Nancy; Goldenberg, Robert // American Journal of Public Health;Oct2008, Vol. 98 Issue 10, p1833 

    Objectives. We examined pregnant women's use of cigarettes and other tobacco products and the exposure of pregnant women and their young children to secondhand smoke (SHS) in 9 nations in Latin America, Asia, and Africa. Methods. Face-to-face surveys were administered to 7961 pregnant women...

  • Client form CONFUSION. Choder, Betsy // DVM: The Newsmagazine of Veterinary Medicine;2013 Hospital of the Year, p8 

    A letter to the editor is presented in response to the article "Client Information Form" in the February 1, 2013 issue.

  • Dr. Salszieder's response.  // DVM: The Newsmagazine of Veterinary Medicine;2013 Hospital of the Year, p8 

    The article argues against the changes to be made to the client form in terms of informed consent.

  • Informed Consent in Sports Health Care. Regan, William F. // Athletic Therapy Today;May99, Vol. 4 Issue 3, p47 

    Focuses on the use of informed consent in sports health care. Basis of the informed consent; Provision of protection to a defendant in a lawsuit; Presentation of guidelines for drafting and providing an informed consent. INSET: Verification of Injury Incidence.

  • Noncompliance by patients. Dimond, B. // Nursing Ethics;Jan1998, Vol. 5 Issue 1, p59 

    Comments on the principle of law on treatment consent in Great Britain. Utilization of the reasonable standard care by health professionals; Impact of the power to act in the best interests of a mentally incompetent adult, on pregnant women; List of noncompliance situations.

  • Myth of Protection: Florida Courts Permitting Involuntary Medical Treatment of Pregnant Women. STUTZ, LACEY // University of Miami Law Review;Summer2013, Vol. 67 Issue 4, p1039 

    The article focuses on the right of the patient to refuse for medical treatment under the affect of the U.S. constitution. Topics discussed include the role of the constitution of Florida, the laws made by different U.S. states to overcome with ones right to refuse for medical treatment, and the...


Read the Article


Sign out of this library

Other Topics