Department of Obstetrics and Gynecology, Trinity College Dublin, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland.
Am J Obstet Gynecol. 2011 Feb;204(2):139.e1-9. doi: 10.1016/j.ajog.2010.10.004. Epub 2010 Dec 8.
The purpose of this study was to examine the relationship among methadone maintenance treatment, perinatal outcomes, and neonatal abstinence syndrome.
This was a retrospective cohort study of 61,030 singleton births at a large maternity hospital from 2000-2007.
There were 618 (1%) women on methadone at delivery. Methadone-exposed women were more likely to be younger, to book late for antenatal care, and to be smokers. Methadone exposure was associated with an increased risk of very preterm birth <32 weeks of gestation (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.40-4.34), being small for gestational age <10th percentile (aOR, 3.27; 95% CI, 2.49-4.28), admission to the neonatal unit (aOR, 9.14; 95% CI, 7.21-11.57), and diagnosis of a major congenital anomaly (aOR, 1.94; 95% CI, 1.10-3.43). There was a dose-response relationship between methadone and neonatal abstinence syndrome.
Methadone exposure is associated with an increased risk of adverse perinatal outcomes, even when known adverse sociodemographic factors have been accounted for. Methadone dose at delivery is 1 of the determinants of neonatal abstinence syndrome.
本研究旨在探讨美沙酮维持治疗、围产期结局和新生儿戒断综合征之间的关系。
这是一项回顾性队列研究，纳入了 2000 年至 2007 年期间在一家大型妇产医院分娩的 61030 例单胎妊娠。
在分娩时，有 618 名（1%）妇女接受美沙酮治疗。美沙酮暴露组的女性更年轻、更晚预约产前保健，且更可能吸烟。美沙酮暴露与早产风险增加相关（调整后的优势比[aOR]，2.47；95%置信区间[CI]，1.40-4.34），小于胎龄儿发生率增加（aOR，3.27；95%CI，2.49-4.28），新生儿需要入住新生儿病房（aOR，9.14；95%CI，7.21-11.57），以及主要先天性畸形的诊断率增加（aOR，1.94；95%CI，1.10-3.43）。美沙酮与新生儿戒断综合征之间存在剂量反应关系。
即使考虑到已知的不良社会人口因素，美沙酮暴露仍与不良围产期结局的风险增加相关。分娩时的美沙酮剂量是新生儿戒断综合征的决定因素之一。
