Vision in children born to mothers taking methadone in pregnancy

Estimates suggest one in every hundred babies in the UK is born to a mother who has a problem with drug abuse.¹ Pregnant women who are addicted to opioid drugs such as heroin are offered a substitute medicine called methadone as part of a harm reduction programme. In 2010, Dr Ruth Hamilton, of Glasgow’s Royal Hospital for Children, studied the eyesight of babies whose mothers were prescribed methadone during pregnancy. She found that most of the mothers misused illicit drugs as well as taking their prescribed methadone, and that their babies were more likely to have vision problems than babies who were not exposed to drugs during pregnancy. Dr Hamilton is investigating whether the babies’ vision problems have persisted into childhood. She hopes to give pregnant women, and policy makers in the NHS, better information to support their choices.

This grant is a jointly funded award from Action Medical Research and The Chief Scientist Office (CSO), Scotland.​

How are children’s lives affected now?

Heroin addiction during pregnancy is a significant health and social problem, which can adversely affect both mother and child.

UK guidelines recommend women are offered methadone as an alternative to heroin with the aim of helping them to stabilise their condition, stop injecting and minimise complications. Their babies seem to grow better and have an increased chance of survival. Although women may want to stop taking drugs altogether, sudden withdrawal of heroin or methadone can also be dangerous for the baby.

It’s important to ensure that women who are addicted to heroin get specialised, supportive care and clear information about both the help that’s available and their options – including the consequences of taking heroin and methadone for them and their baby. The need is high: the number of babies who are suffering withdrawal symptoms from opioid drugs like heroin and methadone after birth is reaching epidemic proportions around the world.²

How could this research help?

“Around eight years ago, we studied 100 babies born to mothers who were prescribed methadone during pregnancy,” says Dr Hamilton. “We found that most of the mothers also misused illicit drugs and that their babies were much more likely than babies who weren’t exposed to drugs in the womb to have reduced sharpness of vision, squints and another vision problem called nystagmus (which means the babies’ eyes moved to and fro uncontrollably). Those babies are around eight years old now, and in this study we aim to find out whether they still have vision problems.”

Information on the safety of methadone and drugs of misuse during pregnancy will benefit policy makers who advise doctors and nurses on how best to care for pregnant women who are using heroin, methadone or other opioid drugs. It will help the women themselves when they are deciding what’s best for them and their baby. It may also mean babies get better treatment for any vision problems they go on to experience during childhood.

References

1. Hidden Harm – Responding to the needs of children of problem drug users. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/120620/hidden-harm-full.pdf  Section 4.10, p53. Website accessed 1 September 2016.

2. Allegaert K et al. Neonatal withdrawal syndrome: reaching epidemic proportions across the globe. Arch Dis Child Fetal Neonatal Ed 2016 Jan;101(1):F2-3.