TY - JOUR T1 - Methadone dose and neonatal abstinence syndrome-systematic review and meta-analysis JF - Addiction Y1 - 2010 A1 - Cleary, B A1 - Donnelly, Jean A1 - Strawbridge, Judith D A1 - Gallagher, Paul J A1 - Fahey, T A1 - Clarke, Mike A1 - Murphy, Deirdre J KW - Cohort Studies KW - Databases, Bibliographic KW - Dose-Response Relationship, Drug KW - Female KW - Humans KW - Infant, Newborn KW - Methadone KW - Narcotics KW - Neonatal Abstinence Syndrome KW - Opioid-Related Disorders KW - Pregnancy KW - Pregnancy Complications KW - Prenatal Exposure Delayed Effects KW - Randomized Controlled Trials as Topic KW - Severity of Illness Index AB - 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. VL - 105 UR - http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.03120.x/abstract IS - 12 ER -