Methadone dose and neonatal abstinence syndrome—systematic review and meta-analysis
Article first published online: 15 SEP 2010
© 2010 The Authors, Addiction © 2010 Society for the Study of Addiction
Volume 105, Issue 12, pages 2071–2084, December 2010
How to Cite
Cleary, B. J., Donnelly, J., Strawbridge, J., Gallagher, P. J., Fahey, T., Clarke, M. and Murphy, D. J. (2010), Methadone dose and neonatal abstinence syndrome—systematic review and meta-analysis. Addiction, 105: 2071–2084. doi: 10.1111/j.1360-0443.2010.03120.x
- Issue published online: 3 NOV 2010
- Article first published online: 15 SEP 2010
- Submitted 11 February 2010; initial review completed 29 March 2010; final version accepted 2 July 2010
- neonatal abstinence syndrome;
- systematic review;
Aim To determine if there is a relationship between maternal methadone dose in pregnancy and the diagnosis or medical treatment of neonatal abstinence syndrome (NAS).
Methods PubMed, EMBASE, the Cochrane Library and PsychINFO were searched for studies reporting on methadone use in pregnancy and NAS (1966–2009). The relative risk (RR) of NAS was compared for methadone doses above versus below a range of cut-off points. Summary RRs and 95% confidence intervals (CI) were estimated using random effects meta-analysis. Sensitivity analyses explored the impact of limiting meta-analyses to prospective studies or studies using an objective scoring system to diagnose NAS.
Results A total of 67 studies met inclusion criteria for the systematic review; 29 were included in the meta-analysis. Any differences in the incidence of NAS in infants of women on higher compared with lower doses were statistically non-significant in analyses restricted to prospective studies or to those using an objective scoring system to diagnose NAS.
Conclusions Severity of the neonatal abstinence syndrome does not appear to differ according to whether mothers are on high- or low-dose methadone maintenance therapy.