High-dose methadone maintenance in pregnancy: maternal and neonatal outcomes

Am J Obstet Gynecol. 2005 Sep;193(3 Pt 1):606-10. doi: 10.1016/j.ajog.2005.03.072.


Objective: This study assesses the effect of higher doses of methadone during pregnancy on maternal and fetal outcomes.

Study design: We retrospectively reviewed clinical data for 81 mothers who received methadone and their 81 offspring. The cohort was divided into high-dose (>/=100 mg) and low-dose (<100 mg) groups.

Results: There were no differences in the rate of medication treatment for neonatal abstinence symptoms or days of infant hospitalization between the high-dose (mean, 132 mg) and low-dose (mean, 62 mg) groups. Despite longer histories of opiate abuse, the high-dose group had less illicit drug use at delivery. The whole cohort, which received an average of 101 mg/d, had an 81% rate of negative toxicology screens at delivery.

Conclusion: High doses of methadone were not associated with increased risks of neonatal abstinence symptoms but had a positive effect on maternal drug abuse. Arbitrarily limiting methadone dose as a way of minimizing the risks of neonatal abstinence symptoms may be unwarranted.

MeSH terms

  • Adult
  • Analgesics, Opioid / administration & dosage*
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Length of Stay
  • Methadone / administration & dosage*
  • Neonatal Abstinence Syndrome / epidemiology*
  • Opioid-Related Disorders / rehabilitation*
  • Pregnancy
  • Pregnancy Complications / rehabilitation*
  • Pregnancy Outcome


  • Analgesics, Opioid
  • Methadone