Effect of Substitution Therapy on the Birth Weight of Newborns, Postpartum Adaptation, Trophism and Course of the Neonatal Abstinence Syndrome

Aim: Evaluation of the effect of substitution therapy on the birth weight of the newborn, its postpartum adaptation and course of the neonatal abstinence syndrome. Patients and methods: We studied heroin-addicted women and women undergoing methadone and buprenorphine substitution. During the 3 years we concentrated on 47 heroin-addicted women and 60 women under substitution for prenatal screening, labour and delivery. Results: Birth weight of newborns was lowest in the group of heroin-addicted women as compared to the group receiving substitution with buprenorphine p < 0.01 and to the group of methadone-substituted patients p < 0.05. The highest number of changes in the placenta was exhibited by heroin users, both when compared to methadone users (p < 0.01) and buprenorphine users (p < 0.001). The highest statistically significant number of newborns with IUGR symptoms were born to heroin-addicted women. The lowest Apgar score was recorded in all three evaluations in the group of buprenorphine users and the highest in methadone-substituted women. Conclusions: Substitution therapy provides pregnant women with the possibility of social stabilization and adequate prenatal care. With regard to the fact that methadone substitution protracts the newborn´s abstinence syndrome, attention has been recently focused on substitution with buprenorphine that seems to be from this viewpoint a more considerate option.