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Methadone dose and neonatal abstinence syndrome-systematic review and meta-analysis

Forfatter(e)
Cleary, B. J. Donnelly, J. Strawbridge, J. Gallagher, P. J. Fahey, T. Clarke, M. Murphy, D. J.
År
2010
DOI
10.1111/j.1360-0443.2010.03120.x
Tidsskrift
Addiction
Sider
2071-2084
Kategori(er)
Rus (alkohol, illegale rusmidler)
Tiltakstype(r)
Tiltak rettet mot gravide og barselkvinner
Abstract

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.