Abstract
Twenty-one neonates of drug-dependent mothers were studied prospectively. Of 19 mothers on methadone (M), 13 were polydrug abusers (PD); 2 mothers were heroin-dependent. Mean birth weight was 2675 grams ± 580 (SD); mean gestational age was 38.0 weeks ± 2.7 (SD). Eighteen of 21 had birth weights appropriate for dates; 3 were small for dates. All lengths were between 10th and 90th percentile. Eighteen of 21 head circumferences were between the 10th and 90th percentile; 3 fell below the 10th percentile. Mean maximal weight loss in the first postnatal week was 7.25% of body weight ± 3.67% (SD). From 7 to 30 days of age, 16 infants gained weight normally, 3 subnormally and 2 excessively. Weight gain corrected for caloric intake was inversely related to severity of withdrawal on day 14 (p<.05), but not on days 7 or 21. Drug withdrawal was assessed twice daily by standardized score. Mean time of symptom onset was 13.5 hours ± 0.7 (SD). No difference in withdrawal severity was seen between the M and PD groups. No correlation was found between withdrawal severity and maternal M dosage late in pregnancy or at delivery. Term infants showed more severe withdrawal than preterm infants. Infants randomly treated for moderate to severe symptoms with paregoric or phenobarbital showed no difference in modification of withdrawal severity or treatment time required.
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