Department of Psychological Medicine, University of Auckland, New Zealand.
Neurotoxicol Teratol. 2010 May-Jun;32(3):406-13. doi: 10.1016/j.ntt.2010.01.007. Epub 2010 Jan 25.
In recent decades there has been an increase in the methadone dosages prescribed for opioid dependent women during pregnancy. Using prospective longitudinal data from a cohort of 32 methadone exposed and 42 non-methadone exposed infants, this study examined the relationship between maternal methadone dose during pregnancy and a range of infant clinical outcomes. Of particular interest was the extent to which any observed associations might reflect the direct causal effects of maternal methadone dose and/or the confounding effects of adverse maternal lifestyle factors correlated with methadone use during pregnancy. Findings revealed the presence of clear linear relationships between the mean methadone dose prescribed for mothers during pregnancy and a range of adverse infant clinical outcomes. With increasing maternal methadone dose there was a corresponding increase in infants' risk of being born preterm, being symmetrically smaller, spending longer periods in hospital and the need for treatment for Neonatal Abstinence Syndrome. After due allowance for potentially confounding maternal health and lifestyle factors, maternal methadone dose during pregnancy remained a significant predictor of preterm birth, growth, and the duration of infant hospitalization post delivery. These findings suggest a need to examine more closely the potential impacts of recent trends towards the use of higher methadone dose levels during pregnancy.
近几十年来，怀孕期间为阿片类药物依赖的女性开具的美沙酮剂量有所增加。本研究使用 32 名美沙酮暴露婴儿和 42 名非美沙酮暴露婴儿的队列前瞻性纵向数据，研究了母亲怀孕期间美沙酮剂量与一系列婴儿临床结局之间的关系。特别感兴趣的是，观察到的任何关联在多大程度上可能反映了母亲美沙酮剂量的直接因果效应，以及与怀孕期间使用美沙酮相关的不良母亲生活方式因素的混杂效应。研究结果显示，母亲怀孕期间规定的平均美沙酮剂量与一系列不良婴儿临床结局之间存在明显的线性关系。随着母亲美沙酮剂量的增加，婴儿早产、对称生长不良、住院时间延长以及需要治疗新生儿戒断综合征的风险相应增加。在适当考虑了可能混杂的产妇健康和生活方式因素后，母亲怀孕期间的美沙酮剂量仍然是早产、生长和婴儿分娩后住院时间的重要预测因素。这些发现表明，有必要更仔细地研究最近怀孕期间使用较高美沙酮剂量水平的趋势可能带来的影响。
