A Pilot Study of the Nutritional Status of Opiate-Using Pregnant Women on Methadone Maintenance Therapy

Abstract

Pregnant women in methadone maintenance therapy may have poor nutrition during pregnancy. In 2006–2008, methadone-treated pregnant women (n = 22) were recruited at an urban academic medical center and compared with nondrug-using pregnant women (n = 119) at 20–35 weeks’ gestation. We measured adiposity using prepregnancy body mass index (BMI), dietary intake using a food frequency questionnaire, and micronutrient and essential fatty acid status using biomarkers. Methadone-treated women had lower BMI, consumed more calories, had lower serum carotenoid concentrations, and higher plasma homocysteine concentrations than controls. The study's limitations and implications for future research are discussed.

RÉSUMÉ

Une étude préliminaire du statut alimentaire de l'opiacé maltraitant les femmes enceintes sur la thérapie d'entretien de méthadone.

Les femmes enceintes dans la thérapie d'entretien de méthadone peuvent avoir la nutrition pauvre pendant la grossesse. En 2006–2008, la méthadone les femmes enceintes traitées (n = 22) ont été recrutées à un centre médical d'universitaire urbain et comparées à la non-drogue en utilisant les femmes enceintes (n = 119) à la gestation des semaines 20–35. Nous avons mesuré l'adiposity en utilisant l'index de la masse de corps de pré-grossesse (BMI), l'ingestion diététique en utilisant un questionnaire de fréquence de nourriture, et le statut de micronutrient et essentiel d'acide gras en utilisant des biomarkers. La méthadone a traité des femmes a eu le BMI inférieur, consommé plus de calories, a eu des concentrations inférieures en carotenoïde de sérum et des concentrations plus élevées en homocystéine de plasma que des commandes. Les limitations et les implications de l’étude pour la future recherche sont discutées.

RESUMEN

Un estudio experimental del estado alimenticio del nacrótico que abusa de mujeres embarazadas en terapia del mantenimiento de la metadona.

Las mujeres embarazadas en terapia del mantenimiento de la metadona pueden tener nutrición pobre durante embarazo. En 2006–2008, la metadona las mujeres embarazadas tratadas (n = 22) fue reclutada en un centro médico académico urbano y comparada con la no-droga usando a mujeres embarazadas (n = 119) en la gestación de las semanas 20–35. Medimos adiposity usando el índice de la masa del cuerpo del pre-embarazo (BMI), la ingestión dietética usando un cuestionario de la frecuencia del alimento, y el estado del microalimento y esencial del ácido graso usando biomarkers. La metadona trató a mujeres hizo un BMI más bajo, consumir más calorías, tenía concentraciones más bajas del carotenoid del suero y concentraciones más altas del homocysteine del plasma que controles. Las limitaciones y las implicaciones del estudio para la investigación futura se discuten.

Keywords :

• methadone
• pregnancy
• nutrition
• obesity
• dietary intake
• nutritional biomarkers

THE AUTHORS

Laura E. Tomedi, M.P.H., was a doctoral candidate in the Department of Epidemiology at the Graduate School of Public Health, University of Pittsburgh, PA, at the time when this study was conducted. Her work has primarily been in gestational diabetes mellitus, maternal nutrition, obesity, and substance abuse research.

Debra L. Bogen, M.D., is an Associate Professor of Pediatrics at the School of Medicine, University of Pittsburgh, and the Director of the Primary Care Physician Faculty Development Fellowship. Her research interests include assessing effect of the relationship between maternal mental health and nutrition on infant growth, behavior, and development and on the promotion of childhood nutrition. For example, assessing behavioral and developmental outcomes associated with nutritional deficiencies. She also conducts medical education on the evaluation of a newborn nursery curriculum and breast-feeding education of healthcare professionals.

Barbara H. Hanusa, Ph.D., was a Research Assistant Professor in the Department of Psychiatry, School of Medicine, University of Pittsburgh, when this work was completed. She currently works as a senior biostatistician at the Pittsburgh Veterans Hospital System, Center for Health Equities Research and Promotion (CHERP), and Mental Illness Research, Education and Clinical Center (MIRECC).

Katherine L. Wisner, M.D., M.S., is the Director of the Women's Behavioral HealthCARE of the Western Psychiatric Institute and Clinic in Pittsburgh, PA. Her major interest area is women's health across the life cycle, with a particular focus on childbearing. She published the only two placebo-controlled randomized drug trials for the prevention of recurrent postpartum depression and performed the first comparative drug study for postpartum depression.

Lisa M. Bodnar, Ph.D., M.P.H., R.D., is an Assistant Professor in the Department of Epidemiology at the Graduate School of Public Health, University of Pittsburgh. She works primarily in nutritional epidemiology and reproductive health. Her research interests include assessing maternal nutritional status and its effect on birth outcomes, nutritional psychiatry in the perinatal period, the reproductive consequences of obesity, and causal modeling and longitudinal data analysis in reproductive epidemiology.