Methadone maintenance program in a Swiss perinatal center: (I): Management and outcome of 89 pregnancies
Article first published online: 31 JAN 2005
Acta Obstetricia et Gynecologica Scandinavica
Volume 84, Issue 2, pages 140–144, February 2005
How to Cite
Kashiwagi, M., Arlettaz, R., Lauper, U., Zimmermann, R. and Hebisch, G. (2005), Methadone maintenance program in a Swiss perinatal center: (I): Management and outcome of 89 pregnancies. Acta Obstetricia et Gynecologica Scandinavica, 84: 140–144. doi: 10.1111/j.0001-6349.2005.00497.x
- Issue published online: 31 JAN 2005
- Article first published online: 31 JAN 2005
- Submitted 28 July, 2003; Accepted 1 December, 2003
- heroin-assisted treatment;
- maintenance program;
Background. Although methadone maintenance is the standard treatment of opiate addiction in pregnancy, opinion as to its utility is divided. The aim of this study was to analyze polydrug abuse, pregnancy outcome and fetomaternal complications among pregnant women in a major Swiss methadone maintenance program.
Methods. Prospective data collection of all pregnant opiate addicts and their neonates from 1996 to 2001.
Results. Maternal complications occurred in 73% and fetal complications in 34% of the pregnancies. The average methadone dose at delivery in the 89 pregnancies was 40.9 ± 32.7 (0–150) mg/day. Sixty-four percent of the women were co-users of cocaine and/or heroin. Birthweight was lower in polydrug abusers than in near-exclusive methadone users (p = 0.001).
Conclusion. The high rate of maternal complications demonstrates the need for further improvement in antenatal management of opiate addiction in pregnancy. Methadone maintenance is inefficient in preventing pregnancy exposure to additional illicit drug consumption. Additional illicit heroin and/or cocaine abuse does not seem to increase the incidence of fetomaternal complications during pregnancy, but reverses the positive impact of methadone on birthweight. Heroin-assisted treatment may be a more effective method of minimizing the use of street drugs.