Methadone versus morphine treatment outcomes in neonatal abstinence syndrome: A meta-analysis

J Paediatr Child Health. 2019 Oct;55(10):1177-1182. doi: 10.1111/jpc.14609. Epub 2019 Sep 3.

Abstract

Aim: To determine whether morphine has better outcomes for neonatal abstinence syndrome treatment than methadone.

Methods: Studies published before 1 January 2019 were identified using the PubMed, Web of Science, Scopus, Cochrane Library and ClinicalTrials.gov databases. The Cochrane Collaboration Risk of Bias Tool was used to assess the risk of bias for randomised clinical trials. In addition, the risk of bias for non-randomised studies was evaluated by a non-randomised studies of interventions tool.

Results: We identified 1020 published studies, and 5 were included in the final analysis. Results showed no significant difference in opioid treatment days (standardised mean difference (SMD) = 0.32, 95% confidence interval (CI) = -0.16, 0.80), length of hospital stay (SMD = -0.33, 95% CI = -1.21, 0.56) and duration of treatment (SMD = -0.83 95% CI = -2.09, 0.43) between morphine or methadone treatment.

Conclusions: Our meta-analysis of current evidence demonstrated that neonatal abstinence syndrome treatment with morphine was not associated with better outcomes in infants compared with methadone treatment.

Keywords: meta-analysis; methadone; morphine; neonatal abstinence syndrome.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Humans
  • Infant, Newborn
  • Methadone / therapeutic use*
  • Morphine / therapeutic use*
  • Neonatal Abstinence Syndrome / drug therapy*
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Morphine
  • Methadone