Consequences of Prenatal Exposure to Methadone: Chicago, 1978-1984

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Consequences of Prenatal Exposure to Methadone: Chicago, 1978-1984

Investigators: Sydney L. Hans

Publication Date: March 23, 2016

Consequences of Prenatal Exposure to Methadone: Chicago, 1978-1984

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This longitudinal study assessed the effects of prenatal methadone exposure on a cohort of children who were followed from birth to two years of age. The purpose of the study was to examine teratogenic effects of methadone as well as to determine how other non-teratogenic risk factors might be related to the behavior of drug-exposed children. The study was designed to replicate prior research and clinical observations which identified a variety of behaviors and medical conditions that might appear soon after birth for methadone-exposed infants. These included tremulousness, hypertonicity, irritability, incessant high-pitched crying, sleep disturbances, hyperactive reflexes, frantic but weak sucking, regurgitation, yawning, sneezing, nasal congestion, sweating, fever, and convulsions. These behaviors, termed neonatal narcotics abstinence syndrome, bore a close resemblance to withdrawal symptoms observed in adult narcotics addicts, and their presence during the neonatal period had usually been attributed to generalized hyperirritability of the central nervous system caused by withdrawal from opioid drugs following in utero exposure. However, methadone exposure often co-occurred with other factors such as perinatal complications, which might be affecting the neonatal behaviors assumed to be caused by withdrawal from opioids. The study comprised 42 infants delivered by 36 pregnant opioid-using women between the ages of 18 and 35 who were recruited at prenatal clinics at Chicago Lying-In Hospital between 1978 and 1982. All of the women were involved in low-dose methadone-maintenance programs for the treatment of chronic heroin addiction, and the majority occasionally used other drugs, most commonly alcohol, marijuana, heroin, cocaine, Valium, or Talwin. All of the women were black, came from low-income inner-city neighborhoods, and received good quality prenatal care. Infants' behavior was assessed at one day and at four weeks of age using the Neonatal Behavioral Assessment Scale with Kansas Supplements (NBAS-K). The children were assessed again at 4, 8, 12, 18 and 24 months of age using the Bayley Scales of Infant Development. Children's heights, weights, and head circumferences were measured at each of the assessments. The study assessed a total of 436 variables across 79 cases.

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