ORONO, Maine — Life gets off to a rough start for babies born to drug-dependent women, even when their mothers’ addiction is clinically managed with methadone during pregnancy. Born with their own chemical dependency, approximately 70 percent of these babies spend weeks in intensive care being treated for a cluster of unpleasant and dangerous symptoms of opiate withdrawal known collectively as Neonatal Abstinence Syndrome, or NAS.
Few studies have tracked NAS babies beyond the earliest weeks of their lives, but University of Maine doctoral student Beth Logan is pushing that body of research forward. Data from her Maine Infant Follow-Up Project show that well-managed maternal methadone therapy is not associated with developmental problems in the first year of life, but that frequent methadone increases may be linked with delays in babies’ ability to sit up, crawl and walk, which are important predictors of mental functioning and the ability to learn.
These findings imply it is essential for methadone to be properly managed during pregnancy to avoid frequent dose increases in response to maternal symptoms of withdrawal.
A mother’s use of alcohol while in methadone treatment also appears to be linked to developmental delays, according to the study.
Clinicians at Eastern Maine Medical Center in Bangor and Maine Medical Center in Portland are at the national forefront of managing NAS babies, and their experience is guiding the way for doctors and hospitals in other states.
“It is an enormous social responsibility to be working on such an important problem,” Logan says of her research team, which includes principal investigators UMaine psychology professor Marie Hayes and Dr. Mark Brown, chief of pediatrics and director of nurseries at EMMC.
Logan and her research colleagues have enrolled 110 mother-baby groups in the longitudinal study, which began in 2006. A comparison group of about 30 mothers and their babies has similar demographics, but the mothers in that group are not opiate abusers.
Logan notes that opiate-dependent mothers-to-be typically embody a “perfect storm” of risk factors that can affect the development of their babies, both before and after birth. These include low income, low educational attainment, psychiatric diagnoses such as depression and anxiety and exposure to domestic violence. In addition, their lifestyles often include the abuse of alcohol, tobacco and drugs, poor nutrition, inadequate prenatal care, frequent changes in housing and a lack of family and community support.
While most babies in the study’s control group are standing, cruising and preparing to take their first steps at nine months, nearly 40 percent of babies in the methadone group are still having trouble crawling and sitting.
Logan says the next step is to extend the study to follow the same group of NAS babies through toddlerhood, assessing them at 18, 24 and 36 months of age.