In utero drug and alcohol exposure in infants born to mothers prescribed maintenance methadone

Arch Dis Child Fetal Neonatal Ed. 2013 Nov;98(6):F542-4. doi: 10.1136/archdischild-2013-304158. Epub 2013 Jul 8.

Abstract

Aims: To describe the prevalence of in utero alcohol and illicit drug exposure in infants born to mothers prescribed methadone in pregnancy, and to compare the accuracy of maternal interview with infant toxicology.

Methods: Urine and meconium samples were collected from 56 infants born to mothers prescribed methadone during pregnancy and a confidential interview conducted soon after delivery. Samples were screened for drugs of misuse and meconium samples analysed for the presence of fatty acid ethyl esters (FAEEs) to detect prenatal alcohol exposure.

Results: 91% of infants had been exposed to illicit drugs in utero, including opiates (73%), benzodiazepines (70%) and cannabinoids (59%). 47% of infants had elevated FAEEs. Meconium was more sensitive at detecting in utero drug exposure than urine toxicology (p<0.01 for opiates, benzodiazepines, cannabinoids) or maternal interview (p=0.03 for opiates, p<0.01 for cannabinoids).

Conclusions: The majority of infants born to mothers prescribed methadone during pregnancy are exposed to polysubstance misuse, and almost one-half additionally exposed to excess alcohol.

Keywords: Drug Abuse; Neonatology; Toxicology.

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Central Nervous System Depressants / adverse effects
  • Ethanol / adverse effects*
  • Female
  • Humans
  • Illicit Drugs / adverse effects
  • Infant, Newborn
  • Methadone / adverse effects*
  • Opiate Substitution Treatment / adverse effects*
  • Pregnancy
  • Pregnancy Complications / chemically induced*
  • Prenatal Exposure Delayed Effects / chemically induced*
  • Scotland

Substances

  • Analgesics, Opioid
  • Central Nervous System Depressants
  • Illicit Drugs
  • Ethanol
  • Methadone