7+Prenatal+Development+of+Methadone+Babies

= Fetal Development and Birth Defects =

On this page I hope to give you some information on the risks and advantages of methadone maintenance during pregnancy and its affect on the fetus and newborn baby. Many people think very badly of women who use this treatment during their pregnancy. What would you prefer heroin use or doctor a supervised methadone maintenance program. I myself believe that any women who makes the choice to address her addiction when she becomes pregnant is a very loving, strong and nurturing mother to be. It is certainly not easy to start recovery and some women cannot do this even though they love their yet unborn child. Addiction is a powerful curse that is very hard to overcome. Below I have borrowed some information from experienced professional people who know much more about all this then I. I hope you can gain a new respect for anyone who makes the choice to enter a methadone maintenance program and who wants to give their fetus the best chance at a good life as they can. I personall have a daughter born from this situation and she is an amazing child who as of yet has shown no ill afffects from her mother's amazing choice to use a methadone program instead od the evils of opiod addiction.

My daughter, Bianca. A child who might not be here if not for methadone maintenance and the support of incredible doctors and their belief in the program.

Methadone and Herion at The Prenatal Stage __ : __ "Methadone is used to treat heroin addicts and is a relatively safe alternative to relapse, heroin addiction or withdrawal, but it is still an opiate narcotic. Methadone-exposed infants have poorer fine and gross motor coordination at birth. By age 5, these children are more active, engage in task irrelevant activity and have poorer fine-motor coordination than controls. There are conflicting reports regarding the effects of prenatal opioid exposure on cognitive development in toddlers and preschoolers. Observations of delayed mental and motor development may be due to poor environmental conditions or methadone may produce subtle neurological changes making children more susceptible to the developmental delays associated with impoverished environments ." (@http://www.intoxikon.com/Pubs/Facts%20on%20FETAL%20DRUG%20EFFECTS_4_7_05.pdf (Brick, 2005)

4 **Breastfeeding.** Breastfeeding is encouraged if the woman is HIV-seronegative and not abusing other drugs. Instead, methadone appears to reduce risks to both mother and infant by preventing illicit drug use. Methadone is often substituted for heroin and other opiates when patients are treated for their addiction. When the methadone dose is high enough, it blocks the effects of heroin and reduces addicts' craving for the drug. Many physicians believe that methadone doses should be kept no higher than 20 milligrams per day when women are pregnant, lead investigator Dr. Vincenzo Berghella told Reuters Health. But effective doses for pregnant women range from 50 to 200 mg daily. Therefore, his research group, based at Jefferson Medical College of Thomas Jefferson University in Philadelphia, examined the records of 100 mother-newborn pairs treated in their comprehensive program for drug-addicted pregnant women. Methadone doses ranged from 20 to 200 mg per day, they note in their article in the American Journal of Obstetrics and Gynecology. Their study differed from previous research, they point out, because it examines higher average doses and the last dose prior to delivery. They also scored the newborns' withdrawal problems using an objective measure of clinical signs and symptoms, called the Newborn Abstinence Score (NAS). Birth weight, highest NAS, presence of neonatal withdrawal, and average duration of treatment for withdrawal did not differ significantly between the higher doses and lower doses of methadone. 'I was happily surprised when our data confirmed that using an effective dose is best for both the women and their babies,' Berghella said. He added that prior research demonstrated that methadone has no long-term effects on the fetus, 'just short-term withdrawal,' which occurred in 60 percent of the babies. 'Effective maintenance prevents drug hunger and craving and blocks the euphoric effect of illicit drugs,' he noted. As a result, the fetus is not exposed to erratic maternal opioid levels, protecting it from repeated episodes of withdrawal. Furthermore, he said, 'by preventing drug-seeking behavior, women are less likely to engage in prostitution or other behaviors that increase their risk of HIV, hepatitis infection, and other sexually transmitted diseases.' He advises heroin-addicted women to check into a program that not only helps them with their symptoms of withdrawal, but also addresses psychological and social issues. The program at Jefferson Medical College 'even helps women find housing, stay away from an abusive partner, and provides basic preventive medical care. 'That way, people can become clean and can stay clean,' Berghella concluded.([]*) (Shrira, Deborah:,2010)
 * The neonatal effects of methadone may include:**
 * 1 Abstinence Syndrome.** The neonate suffers an abstinence syndrome similar to that seen with heroin. **The abstinence syndrome for methadone usually starts later and lasts longer (due to longer half life) than for heroin.** Central nervous system signs are prominent. Electroencephalograms (EEGs) are abnormal in about 50 percent of the infants. Seizures occur in about 7 percent of the infants, tend to occur between days 7 and 14, and are primarily myoclonic. Abstinence is more variable in onset and course than with heroin. Exposure to both heroin and methadone may produce a biphasic or atypical pattern of withdrawal.
 * 2 Fetal growth and reduced perinatal mortality.** Multiple risk factors may contribute to poor fetal growth in methadone-exposed children. **Although birth weight** **and head size may be reduced, fetal growth is generally more normal than with heroin**, **and may be related to the first trimester dosage of methadone**. Reduced perinatal mortality compared with heroin use may be due to positive changes in lifestyle including increased prenatal care.
 * 3 Postnatal effects.** The postnatal weight change pattern may be suboptimal if the infant is hypermetabolic. A thrombocytosis may develop during the second week of life and peak at about the eighth week before returning to normal. There is biochemical evidence of hyperthyroidism in some infants.
 * 5 Delayed effects.** Delayed effects may include an increased incidence of SIDS. Long-term followup studies are incomplete and difficult to interpret. Generally, infants have performed within the normal range and no major neurologic or developmental disabilities have been reported.
 * 6 No effect.**
 * Treating heroin-addicted pregnant women with the most effective dose of methadone does not increase their infants' symptoms of withdrawal after they are born, new study findings suggest.**

Scope and Nature of the Problem
The use of psychoactive drugs during pregnancy can place at risk the expectant mother, fetus, newborn and child. This represents a problem affecting all socioeconomic and ethnic classes, in countries throughout the world, and the associated costs are borne by the entire society. In the United States in 1992, the National Institute on Drug Abuse estimated that of some 4 million births, one or more illicit drugs were taken during pregnancy by 5.5 percent, or 221,000, of the mothers. The incidence of use varies with geographic location, socioeconomic status and educational level. Drug dependence during pregnancy is a complex biopsychosocial problem that presents multiple challenges. When assessing the impact of addiction on the pregnant woman and, ultimately, her infant, one must consider the environmental problems they face. The cycle of addiction not only includes illicit and licit drug use and its direct concomitants, but also family dysfunction, physical and sexual abuse, social issues, legal problems and educational deficits, unemployment, etc. Because of this extremely high-risk environment, and the pregnant drug-dependent woman's frequent lack of prenatal care, the infant is predisposed to a host of neonatal problems in addition to the pharmacologic effect of the substance used. Many are due to low birth weight and prematurity – e.g., asphyxia neonatorum, intracranial hemorrhage, respiratory distress syndrome, intrauterine growth retardation, hypoglycemia, hypocalcemia, septicemia and hyperbilirubinemia. For injecting drug users, the most frequently encountered medical problems include: infections (cellulitis, hepatitis, pneumonia, bacterial endocarditis, sexually transmitted diseases and HIV), anemia, thombocytopenia, thrombophlebitis, overdose and multiple injuries from trauma. In women using heroin, fetal wastage can result from spontaneous abortion, intrauterine death, amnionitis, chorioamnionitis, gestational diabetes, and premature rupture of the membranes and septicemia. Placental disorders that may occur include abruption, infarction and insufficiency. Lack of prenatal care also predisposes to pre-eclampsia and eclampsia. The most commonly seen obstetrical complications are preterm birth and intrauterine growth retardation. In addition, heroin-addicted women are at heightened risk of hemorrhage following delivery. (http://dc-addicts-durham.wikispaces.com/7+Prenatal+Development+of+Methadone+Babies) (Finnegan, MD, 2006)

=Video of: Methadone Effects On A Fetus= media type="youtube" key="Y_arRf4boGQ?fs=1" height="385" width="640" (Bosworth,2009)