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    Methadone dose and neonatal abstinence syndrome-systematic review and meta-analysis.

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    Authors
    Cleary, Brian J
    Donnelly, Jean
    Strawbridge, Judith
    Gallagher, Paul J
    Fahey, Tom
    Clarke, Mike
    Murphy, Deirdre J
    Affiliation
    Coombe Women and Infants University Hospital, Dublin 8, Ireland School of, Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland., bcleary@coombe.ie
    Issue Date
    2012-02-01T10:58:32Z
    MeSH
    Cohort Studies
    Databases, Bibliographic
    Dose-Response Relationship, Drug
    Female
    Humans
    Infant, Newborn
    Methadone/*administration & dosage/adverse effects
    Narcotics/*administration & dosage/adverse effects
    Neonatal Abstinence Syndrome/*epidemiology/etiology
    Opioid-Related Disorders/*drug therapy
    Pregnancy
    Pregnancy Complications/*drug therapy
    Prenatal Exposure Delayed Effects
    Randomized Controlled Trials as Topic
    Severity of Illness Index
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    Citation
    Addiction. 2010 Dec;105(12):2071-84. doi: 10.1111/j.1360-0443.2010.03120.x. Epub , 2010 Sep 15.
    Journal
    Addiction (Abingdon, England)
    URI
    http://hdl.handle.net/10147/208042
    DOI
    10.1111/j.1360-0443.2010.03120.x
    PubMed ID
    20840198
    Abstract
    AIM: To determine if there is a relationship between maternal methadone dose in pregnancy and the diagnosis or medical treatment of neonatal abstinence syndrome (NAS). METHODS: PubMed, EMBASE, the Cochrane Library and PsychINFO were searched for studies reporting on methadone use in pregnancy and NAS (1966-2009). The relative risk (RR) of NAS was compared for methadone doses above versus below a range of cut-off points. Summary RRs and 95% confidence intervals (CI) were estimated using random effects meta-analysis. Sensitivity analyses explored the impact of limiting meta-analyses to prospective studies or studies using an objective scoring system to diagnose NAS. RESULTS: A total of 67 studies met inclusion criteria for the systematic review; 29 were included in the meta-analysis. Any differences in the incidence of NAS in infants of women on higher compared with lower doses were statistically non-significant in analyses restricted to prospective studies or to those using an objective scoring system to diagnose NAS. CONCLUSIONS: Severity of the neonatal abstinence syndrome does not appear to differ according to whether mothers are on high- or low-dose methadone maintenance therapy.
    Language
    eng
    ISSN
    1360-0443 (Electronic)
    0965-2140 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1360-0443.2010.03120.x
    Scopus Count
    Collections
    Coombe Women & Infants University Hospital

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