Arch Dis Child Fetal Neonatal Ed 96:F457-F460 doi:10.1136/adc.2009.181057
  • Reviews

The management of heroin misuse in pregnancy: time for a rethink?

  1. Helen Mactier
  1. Correspondence to Dr Helen Mactier, Neonatal Unit, Princess Royal Maternity, 8-16 Alexandra Parade, Glasgow G31 2ER, Scotland; helen.mactier{at}
  • Accepted 12 May 2010
  • Published Online First 28 June 2010


Heroin use in pregnancy is a worldwide problem. Methadone maintenance treatment has definite advantages for the mother and is currently recommended in the UK. There is, however, increasing evidence of adverse effects upon developing cortical and visual function in children of treated heroin-addicted mothers. The longer-term implications of this are not yet clear, and are confounded by poly-drug misuse and ongoing social deprivation. There is a paucity of evidence regarding outcome for infants who require pharmacological treatment for neonatal abstinence syndrome compared to those who have only mild symptoms. Well-controlled studies of the treatment of heroin misuse in pregnancy that take account of both neonatal and longer term outcomes for the child are urgently required.


  • Funding None.

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.

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