02 May Methadone Use During Pregnancy Leads to Low Birth Weight
Methadone is an opioid medication most commonly used to treat people addicted to heroin, an opioid drug known for its powerful effects on the human brain and body. Current evidence indicates that women who regularly use this medication during pregnancy develop strongly increased chances of having children with unusually low birth weights. In a study published in January 2014 in the journal Addiction, researchers from four Scottish institutions sought to identify the factors that contribute to low birth weight in the newborn children of methadone-using mothers. The researchers concluded that they could not fully account for this phenomenon.
Methadone was developed in the 1930s as a painkiller with less potential for producing addiction than another well-known opioid pain reliever called morphine. Its employment as a treatment for heroin addiction was first established in the 1960s. Doctors use methadone in the context of addiction treatment to help recovering addicts avoid the potentially severe symptoms of heroin withdrawal. Essentially, the medication produces enough of an opioid effect to stave off the impact of withdrawal symptoms, but does not produce enough of an opioid effect to promote the harmful, uncontrolled behaviors that characterize heroin addiction. Many recovering addicts participate in methadone maintenance treatment, an approach that uses methadone as an opioid replacement for an open-ended amount of time. Others only receive the medication temporarily while detoxifying from heroin use
Impact on Pregnancy
The use of methadone in pregnant, recovering opioid addicts dates back to the 1970s. In some cases, treatment with the medication predates the beginning of a pregnancy. In other cases, women addicted to heroin start taking methadone after becoming pregnant. Potential benefits of methadone use during pregnancy include reducing the chances that a developing fetus will be exposed to the fairly dramatic body changes associated with opioid withdrawal, reducing the chances that a pregnant opioid addict will participate in dangerous drug-oriented behaviors and increasing the chances that a pregnant opioid addict will receive proper prenatal care.
Unfortunately, use of methadone during pregnancy can also heighten certain pregnancy-related risks. Prominent among these risks is the possibility of giving birth to a child with unusually low body weight. As a rule, doctors diagnose low birth weight in any child who weighs less than 5 lbs, 8 oz at birth. Not all babies born below this weight threshold are unhealthy. However, broadly speaking, a low birth weight baby has increased odds for developing a range of potentially serious, debilitating or deadly health complications. Babies born to methadone-using mothers also sometimes have unusually small heads.
Identifying the Relevant Factors
In the study published in Addiction, the team of Scottish researchers used an examination of 366 babies born to 103-methadone using mothers to explore the factors that could potentially explain the presence of unusually low birth weight and head size. They undertook this project because the scientific community does not currently have a firm understanding of the connection between methadone maintenance treatment and observed weight and head size issues in the newborns of women who participate in this treatment. Factors under consideration included cigarette use, a lack of socioeconomic opportunities, the age of methadone-using women during pregnancy and the number of children born to any given methadone-using woman.
The researchers confirmed that, as a whole, the newborn children in the sample group did indeed experience the reduction in birth weight and head size frequently associated with methadone intake. However, when they examined the effects of all of the potential influencing factors, they concluded that the total impact from these factors could not completely explain the observed changes in the methadone-exposed newborns. The researchers could not come up with a plausible additional factor that would help account for these changes.
Significance and Considerations
Further research will be needed before anyone can fully understand why methadone maintenance treatment is associated with such significant decreases in birth weight and newborn head size. It’s important to note that, compared to women using heroin, women using methadone generally produce healthier newborns with higher birth weight and larger head size. In addition, according to findings compiled by the federal Substance Abuse and Mental Health Services Administration, the children born to methadone-using mothers tend to not to develop long-term restrictions on their weight and head size. This means that, in most cases, these particular fetal impacts of methadone use do not produce permanently damaging results.
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