| While alcohol is a known teratogen, little is known about maternal and infant outcomes when alcohol is used in combination with one or more illicit drugs. Variability in drug dosage, frequency of use, and route of administration often prohibits the study of such patterns of comorbidity and their potential contribution to maternal and infant outcomes. The present dataset provides a unique opportunity to study the impact of perinatal alcohol and/or methadone use on infant outcomes. The purpose of the study is to compare infant outcomes in pregnant, methadone-maintained women with (Alc+, n = 60) and without (Alc-, n = 60) comorbid prenatal alcohol use. Study participants were opiate-dependent women admitted to a comprehensive perinatal drug treatment program. They were primarily African-American (77%) and in their late 20's. All participants completed the Addiction Severity Index (ASI), which provided data on recent use of alcohol and other substances. All study participants had been maintained on methadone for at least 8 weeks prior to delivery, with a mean dose of 46 mgs. Based on urine drug toxicology data at delivery, all participants were negative for drug use (excluding methadone). Maternal and infant outcome data were compared using multiple regression analyses, and chi-square, and t-tests. Results of the overall models were significant for head circumference, birthweight, birth length, EGA (wks) at delivery, mean NAS scores, and NAS symptom counts. However, when the effects of maternal methadone dose at delivery, EGA (wks) at admission, opiate drop administration, and duration of maternal smoking (months) were controlled, differences attributed to perinatal alcohol use were apparent only for head circumference and EGA (wks) at delivery (p < .05). Study findings suggest that when prenatal alcohol use occurs in conjunction with methadone, there may be an increased risk for adverse infant outcomes. However, the examination of alcohol effects within the context of other maternal social/demographic and lifestyle characteristics is critical to providing a more complete picture of the myriad of factors in the complex lives of drug dependent women which may contribute to infant outcomes. |
