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Maternal drug use and length of neonatal unit stay


A. Greenough
Department of Child Health
King's College Hospital
London SE5 9RS
Tel: + 44 20 73463037
Fax: + 44 20 79249365


Aims  Infants with neonatal abstinence syndrome (NAS) may require a prolonged neonatal unit admission, which has implications for both their families and bed occupancy. The aim of this study was to test the hypothesis that the duration of neonatal unit stay would be influenced by the type of maternal drug use and particularly prolonged for the infants whose mothers had taken methadone with other substances.

Design  The medical records of infants born at term who were admitted consecutively to a neonatal unit because of NAS were reviewed. Data were collected regarding antenatal and neonatal factors likely to affect neonatal stay. Comparisons were then made between three groups of infants: those whose mothers took methadone alone, methadone plus other drugs or non-methadone opioids.

Setting  Level three neonatal intensive care unit.

Participants  Forty-one infants with a median gestational age of 39 (range 37–42) weeks.

Findings  The 41 infants had a median duration of admission of 30 (range 3–68) days. Thirty-six of the infants required treatment for NAS; their median duration of treatment was 29 (range 6–68) days. The duration of stay and requirement for treatment were greater in the infants exposed to methadone and other drugs compared to those exposed to non-methadone opiods only (P = 0.0212, P = 0.0343, respectively). The duration of stay without requirement for treatment was also longest in the methadone plus other drugs group (P = 0.0117).

Conclusions  Prolonged treatment and neonatal unit stay are influenced by the type of maternal drug abused.