• Neonatal Obstetric Syndrome
  • Kimia Jannati Toupkanloo,1,* Reihane Ghorbanian,2 Amir Hossein Biuk,3 Zeinab Sadat Hosseini,4
    1. Member of Omid research group


  • Introduction: Methadone maintenance therapy is a standard treatment for the management of pregnant women with opioid-dependent. This treatment enhanced neonatal situation and decreased maternal mortality and morbidity. However, methadone can cause neonatal abstinence syndrome (NAS) which is characterized by respiratory distress and hyperirritability of the central nervous system. The incidence of NAS in infants exposed to methadone varies between 13% to 94%. In this paper, we aimed to investigate the relationship between maternal methadone dose and NAS.
  • Methods: We searched the keywords " Neonatal abstinence syndrome " AND "Maternal methadone dose" between 2015 and 2019 in PubMed, EMBASE and Google Scholar databases with no language restrictions. We included case-control, cohort and clinical trial studies. We found 27 articles that only 5 of them were related to our subject.
  • Results: According to the articles, increase maternal methadone dosage has a significant relation with the incidence of NAS. Each 5.5 mg increase in maternal methadone dosage has a direct relationship with 1 additional day of NAS treatment for the infant (P < .001; 95% CI, 0.112-0.255). Also, high maternal methadone dose increases the risk of preterm born, smaller symmetrically and the need for treatment for NAS.
  • Conclusion: The results of the studies show that maternal methadone dose is a significant risk factor for the expansion of NAS. So, it is very important to manage and predict the risk classification of NAS for infants of opioid-dependent mothers. Also, there is a need to investigate more suspicious of the potential effects of new methods towards the usage of higher methadone dose during pregnancy.
  • Keywords: Neonatal abstinence syndrome, Maternal methadone dose, Infant.