Abstract
BackgroundThe prevalence of maternal drug use during pregnancy in North America has been estimated to be as high as 6-10%. The consequences for the newborn include increased risk for perinatal mortality and ongoing physical, neurobehavioral, and psychosocial problems. Methadone is frequently used to wean women off street drugs but is implicated as a cause of adverse fetal/neonatal outcomes itself. The purpose of our study was to test the ability of maternal acupuncture treatment among mothers who use illicit drugs to reduce the frequency and severity of withdrawal symptoms among their newborns.MethodsWe randomly assigned chemically dependent pregnant women at BC Women’s Hospital in Vancouver, British Columbia to daily acupuncture treatments versus usual care. By necessity, neither our participants nor acupuncturists were blinded as to treatment allocation. Our primary outcome was days of neonatal morphine treatment for symptoms of neonatal withdrawal. Secondary neonatal outcomes included admission to a neonatal ICU and transfer to foster care.ResultsWe randomized 50 women to acupuncture and 39 to standard care. When analyzed by randomized groups, we did not find benefit of acupuncture; the average length of treatment with morphine for newborns in the acupuncture group was 2.7 (6.3) compared to 2.8 (7.0) in the control group. Among newborns of women who were compliant with the acupuncture regime, we observed a reduction of 2.1 and 1.5 days in length of treatment for neonatal abstinence syndrome compared to the non-compliant and control groups, respectively. These differences were not statistically significant.ConclusionsAcupuncture may be a safe and feasible treatment to assist mothers to reduce their dosage of methadone. Our results should encourage ongoing studies to test the ability of acupuncture to mitigate the severity of neonatal abstinence syndrome among their newborns.Clinical Trial Registrationhttp://www.clinicaltrials.gov registry: W05-0041
Highlights
The prevalence of maternal drug use during pregnancy in North America has been estimated to be as high as 6-10%
The purpose of this study is to determine the efficacy of daily maternal acupuncture treatments in reducing the frequency and severity of (NAS) among infants born to substance-using women
Outcomes could not be ascertained for 2 women in the acupuncture group and one in the control group because they delivered outside of BC Women’s Hospital at an unknown location
Summary
The prevalence of maternal drug use during pregnancy in North America has been estimated to be as high as 6-10%. Methadone is frequently used to wean women off street drugs but is implicated as a cause of adverse fetal/neonatal outcomes itself. The purpose of our study was to test the ability of maternal acupuncture treatment among mothers who use illicit drugs to reduce the frequency and severity of withdrawal symptoms among their newborns. Methadone treatment is currently the recommended approach to opiate addiction during pregnancy [11]. The purpose of this treatment is to alleviate the symptoms of drug withdrawal in order to prevent use of street drugs. A recent prospective study by this group concluded that neonates exposed to methadone doses ≥ 80 mg required higher cumulative doses of morphine treatment for NAS but attributed this to concomitant use of other drugs [26]. Increased rates of congenital anomalies have been reported in nonrandomized studies, [12,24,27] but these have not yet been evaluated in randomized designs [28] capable of controlling for concomitant consumption of other substances
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