Cocaine Attenuates Neonatal Withdrawal in Methadone-Maintained Mothers† 1226
| Autor: | Lawrence Noble, Jennifer Hartstein, Jing Ja Yoon, Ivan L. Hand, Hee Kim |
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| Rok vydání: | 1997 |
| Předmět: | |
| Zdroj: | Pediatric Research. 41:207-207 |
| ISSN: | 1530-0447 0031-3998 |
| DOI: | 10.1203/00006450-199704001-01245 |
| Popis: | There is conflicting data about the effect of cocaine on the withdrawal of newborns from methadone. We reviewed 85 consecutive cases of newborns born at Bronx Lebanon Hospital Center from January 1993 till February 1996 to mothers in methadone maintenance programs. The age range of the mothers was 18-41 years (mean 30.4± 5.1) with 75% Latino and 22% African-American. Sixty-four women (91%) had prenatal care during the pregnancy and 7% had extramural deliveries. The overall prevalence of illicit drug use within one month prior to delivery was 55%. This was determined by history or a positive infant urine toxicology screen. The mothers were divided into 4 groups: 1. methadone alone (methadone) 38 mothers (45%), 2. cocaine + methadone (cocaine) 13 (15%), 3. opiates + methadone (opiates) 13 (15%), 4. methadone +cocaine+opiates (poly-drug) 21 (25%). There were no significant differences between the groups in birth weight, gestational age, length, head circumference, neonatal morbidity, blood pressure, and exposure to smoking or alcohol. There were several important differences between the groups. The daily dose of methadone was significantly higher in the cocaine group than in the methadone group (76 vs 56 mg, p=0.0036) or the opiate group (55mg, p=0.0050). In addition, mothers using cocaine were enrolled in a methadone program significantly longer than the methadone users (60 vs 25 months, p=0.0015) or opiate users (13 months, p=0.0011). However, the peak total withdrawal score(modified Finnegan 1975) was significantly lower in the cocaine-exposed group than the methadone-exposed group (12 vs 16, p=0.0111) or the opiate-exposed group (16, p=0.0220). The number of hospital days spent withdrawing was also significantly lower with cocaine than methadone (22 vs 34, p=0.0235) or opiate(39, p=0.042). Despite the use of illicit drugs, 44% (20/45) of these newborns were discharged home to their mothers. We conclude that while methadone maintenance programs are hailed as an effective method of preventing illicit drug use, concomitant drug use is still very high and continues to place the newborn at risk both in the immediate neonatal period as well upon discharge home. Cocaine use attenuates the neonatal withdrawal syndrome from methadone, whereas opiate use does not. |
| Databáze: | OpenAIRE |
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