Pregnancy Risk Factor Category: C/D (dangerous especially in prolonged used or at high doses)
Some animal studies have shown teratogenic effects, however, the data collected by Teratogen Information System are complicated by other factors including maternal use of illicit drugs, nutrition supplement, concurrent infections and psychosocial circumstances.
Though, there is improvement being observed in pregnant women with methadone treatment compared to pregnant women using illicit drugs.
Methadone can be detected in the amniotic fluid, cord plasma, and newborn urine. Fetal growth, birth weight, length, head or other s may be affected and decreased in infants born to narcotic-addicted mothers with methadone treatment during pregnancy. Growth deficits do not appear to persist but decreased performance on psychometric and behavioural tests has been found to continue into childhood.
Besides, there is also report of abnormal fetal nonstress tests where withdrawal symptoms in the neonate may be observed up to 2-4 weeks after delivery.
Hence, methadone should be only used during pregnancy when clearly needed where benefits outweigh risk.
Since methadone clearance is increased and half-life is decreased during 2nd and 3rd trimesters of pregnancy, withdrawal symptoms may be observed in the mother and thus, methadone dosage may need to be increased and adjusted or decreasing dosing interval during pregnancy.
Methadone may enter into breast milk and is not recommended to be used during lactation.
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