Narcotic Withdrawal Syndrome in the Newborn
Avron V. Sweet MD1
1 Division of Neonatology, Mount Sinai Medical Center, New York
The passive addiction of fetuses to narcotics has been a matter of record for nearly a hundred years. But even as late as the first half of this century, few physicians were aware of the manifestations of withdrawal by the newborn or its therapy. From the late 1950s, when narcotic addiction increased to become a widespread major health calamity, to the present a great deal has been learned about addiction among pregnant women and its effects upon the fetus and newborn. For two decades addiction was most commonly due to heroin but, following the widespread establishment of methadone maintenance clinics, that synthetic opioid now may be the most frequently encountered addictive agent among pregnant women and their newborn infants in the United States. Some appears as unprescribed "street" methadone, which is usually used with an opiate. Moreover, uncooperative participants in methadone maintenance programs also take opiates. As a consequence, there may be homogeneous groups of pregnant heroin addicts and hornogenous groups of pregnant women taking methadone alone but there is a great deal of drug heterogeneity among addicts. Hence, much is known about opiate addiction in pregnancy and its effects upon the fetus and newborn, but much less is certain about the effects of methadone alone.
