怀孕期间和之后美沙酮维持治疗的变化。

Changes in methadone maintenance therapy during and after pregnancy.

机构信息

Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA.

出版信息

J Subst Abuse Treat. 2011 Dec;41(4):347-53. doi: 10.1016/j.jsat.2011.05.002. Epub 2011 Jul 7.

DOI:10.1016/j.jsat.2011.05.002

PMID:21741197

Abstract

OBJECTIVE

The aim of this study is to better understand anticipated changes in daily methadone doses as a guide for prescription during pregnancy.

METHODS

This retrospective case series involved a single cohort longitudinal design of 139 consecutively chosen women who began methadone therapy before 26 completed gestational weeks. Changes in the single daily dose were based on a standard opiate withdrawal scale and determined from early pregnancy until 6 weeks postpartum.

RESULTS

As gestation advanced, the methadone dose increased (86%) rather than remained the same (8%) or decreased (7%). This gradual increase in daily dose during pregnancy (mean increase = 24 mg, 95% confidence level = 20-28 mg) was statistically significant (p < .001) regardless of the initial maintenance dose. By the sixth postpartum week, most subjects (85%) took within 10 mg of their dose at delivery (mean change in dose = -4 mg, 95% confidence interval = -6 to -2 mg).

CONCLUSIONS

Daily doses of methadone increased until the third trimester, then remained essentially unchanged through the sixth postpartum week.

摘要

目的

本研究旨在更好地了解孕期美沙酮剂量的预期变化，以便为处方提供指导。

方法

这是一项回顾性病例系列研究，采用单队列纵向设计，纳入了 139 名连续选择的在 26 周妊娠完成前开始美沙酮治疗的女性。单一每日剂量的变化基于标准阿片类药物戒断量表，并从早孕确定至产后 6 周。

结果

随着妊娠的进展，美沙酮剂量增加（86%），而不是保持不变（8%）或减少（7%）。这种在孕期逐渐增加每日剂量（平均增加 24 毫克，95%置信区间为 20-28 毫克）是具有统计学意义的（p <.001），无论初始维持剂量如何。到产后第六周，大多数患者（85%）的剂量在分娩时相差 10 毫克以内（剂量变化的平均值为 -4 毫克，95%置信区间为 -6 至 -2 毫克）。