Corrie E McDaniel1,2, Matthew Test3,4, Parimal Deodhar3,4, Rebecca Jennings3, Joanna Bove5, Kristen Carlin6. 1. Department of Pediatrics, University of Washington, Seattle, WA, USA. corrie.mcdaniel@seattlechildrens.org. 2. Division of Women and Children's, Providence St. Joseph's Health System, Renton, WA, USA. corrie.mcdaniel@seattlechildrens.org. 3. Department of Pediatrics, University of Washington, Seattle, WA, USA. 4. Division of Women and Children's, Providence St. Joseph's Health System, Renton, WA, USA. 5. Department of Internal Medicine, Providence St. Vincent Hospital, Portland, OR, USA. 6. Seattle Children's Research Institute, Seattle, WA, USA.
Abstract
OBJECTIVE: Quantify the effect of prenatal polysubstance exposure on neonatal outcomes compared to methadone exposure alone. STUDY DESIGN: This retrospective cohort study compared infants with methadone-only exposure to methadone with additional psychoactive substances. Outcomes included time to maximum Finnegan scores, proportion requiring scheduled morphine, and length of stay (LOS). RESULTS: We identified 323 subjects. The median time to maximum Finnegan score was 38.0 h with 94% peaking within 96 h. Forty-five percent of methadone-only infants were started on scheduled morphine compared to 54% of polysubstance infants (p = 0.10). LOS for polysubstance-exposed infants was 1.30 times longer than infants with methadone-only exposure (95% confidence interval: 1.05, 1.60). CONCLUSIONS: Exposure to methadone with additional psychoactive substances is associated with longer LOS, but not postnatal morphine use or peak withdrawal symptoms. Most infants experience peak withdrawal symptoms within 4 days and may not benefit from longer observation.
OBJECTIVE: Quantify the effect of prenatal polysubstance exposure on neonatal outcomes compared to methadone exposure alone. STUDY DESIGN: This retrospective cohort study compared infants with methadone-only exposure to methadone with additional psychoactive substances. Outcomes included time to maximum Finnegan scores, proportion requiring scheduled morphine, and length of stay (LOS). RESULTS: We identified 323 subjects. The median time to maximum Finnegan score was 38.0 h with 94% peaking within 96 h. Forty-five percent of methadone-only infants were started on scheduled morphine compared to 54% of polysubstance infants (p = 0.10). LOS for polysubstance-exposed infants was 1.30 times longer than infants with methadone-only exposure (95% confidence interval: 1.05, 1.60). CONCLUSIONS: Exposure to methadone with additional psychoactive substances is associated with longer LOS, but not postnatal morphine use or peak withdrawal symptoms. Most infants experience peak withdrawal symptoms within 4 days and may not benefit from longer observation.