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Growth restriction in pregnancies of opioid-dependent mothers
  1. A J W Liu1,
  2. S Sithamparanathan1,
  3. M P Jones2,
  4. C-M Cook1,
  5. R Nanan1
  1. 1Discipline of Paediatrics, Sydney Medical School Nepean, The University of Sydney, Penrith, New South Wales, Australia
  2. 2Department of Psychology, Macquarie University, North Ryde, New South Wales, Australia
  1. Correspondence to Dr Anthony J W Liu, Discipline of Paediatrics, Nepean Hospital, Level 5 South Block, Penrith 2751, New South Wales, Australia; liua{at}


Background and aims Intrauterine growth restriction (IUGR) can lead to significant intellectual and behavioural problems in later life. IUGR represents a frequent feature of pregnancies of opioid-dependent mothers (ODMs), the causes of which are largely unknown. The objective of this study was to determine the independent risk factors for IUGR in ODMs.

Design and subjects We performed a retrospective study analysing maternal and neonatal parameters from pregnancies of ODM maintained on methadone (n=215). These were compared to smoking non-ODM and non-smoking non-ODM control groups matched for maternal age, gestational age at delivery, infant birth date and sex. Logistic regression analysis was performed on all parameters with the outcome of IUGR.

Results Fifty-seven infants (27%) of ODMs showed IUGR. Compared to non-smoking non-ODMs, the risk of IUGR in non-smoking ODMs was almost four times higher (relative risk 3.48, 95% CI 1.70 to 7.14). Growth restriction was independent of the last maternal methadone dose and the cumulative methadone dose during pregnancy. In addition, whereas nicotine and female sex impacted on IUGR in non-ODMs (nicotine: OR 3.45, 95% CI 1.82 to 6.67; sex: OR 2.37, 95% CI 1.25 to 4.50), these parameters had no influence on IUGR in ODMs. Maternal body mass index (BMI) was identified as the only independent risk factor for IUGR in infants of ODMs (OR 1.15, 95% CI 1.03 to 1.28).

Conclusions IUGR in pregnancies of ODM is related to maternal BMI rather than to opiate dosing, nicotine use or infant sex. BMI may itself be an indirect marker of several other genetic, nutritional and/or social determinants of IUGR.

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  • AJWL and SS authors contributed equally to this work.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Sydney West Area Health Service Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.