Maternal methadone dosing schedule and fetal neurobehaviour

Lauren M Jansson, Janet Ann DiPietro, Martha Velez, Andrea Elko, Heather Knauer, Katie T. Kivlighan

Research output: Contribution to journalArticle

Abstract

Objective. Daily methadone maintenance is the standard of care for opiate dependency during pregnancy. Previous research has indicated that single-dose maternal methadone administration significantly suppresses fetal neurobehaviours. The purpose of this study was to determine if split-dosing would have less impact on fetal neurobehaviour than single-dose administration. Methods. Forty methadone-maintained women were evaluated at peak and trough maternal methadone levels on single- and split-dosing schedules. Monitoring sessions occurred at 36- and 37-weeks gestation in a counterbalanced study design. Fetal measures included heart rate, variability, accelerations, motor activity and fetal movement-heart rate coupling (FM-FHR). Maternal measures included heart period, variability, skin conductance, respiration and vagal tone. Repeated measure analysis of variance was used to evaluate within-subject changes between split- and single-dosing regimens. Results. All fetal neurobehavioural parameters were suppressed by maternal methadone administration, regardless of dosing regimen. Fetal parameters at peak were significantly lower during single versus split methadone administration. FM-FHR coupling was less suppressed from trough to peak during split-dosing versus single-dosing. Maternal physiologic parameters were generally unaffected by dosing condition. Conclusion. Split-dosed fetuses displayed less neurobehavioural suppression from trough to peak maternal methadone levels as compared with single-dosed fetuses. Split-dosing may be beneficial for methadone-maintained pregnant women.

Original languageEnglish (US)
Pages (from-to)29-35
Number of pages7
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume22
Issue number1
DOIs
StatePublished - Jan 2009

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Methadone
Appointments and Schedules
Mothers
Opiate Alkaloids
Fetus
Fetal Movement
Pregnancy
Fetal Heart Rate
Standard of Care
Pregnant Women
Analysis of Variance
Respiration
Motor Activity
Heart Rate
Skin
Research

Keywords

  • Fetal neurobehaviour
  • Fetus
  • Methadone
  • Methadone dosing
  • Pregnancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Maternal methadone dosing schedule and fetal neurobehaviour. / Jansson, Lauren M; DiPietro, Janet Ann; Velez, Martha; Elko, Andrea; Knauer, Heather; Kivlighan, Katie T.

In: Journal of Maternal-Fetal and Neonatal Medicine, Vol. 22, No. 1, 01.2009, p. 29-35.

Research output: Contribution to journalArticle

Jansson, Lauren M ; DiPietro, Janet Ann ; Velez, Martha ; Elko, Andrea ; Knauer, Heather ; Kivlighan, Katie T. / Maternal methadone dosing schedule and fetal neurobehaviour. In: Journal of Maternal-Fetal and Neonatal Medicine. 2009 ; Vol. 22, No. 1. pp. 29-35.
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