Visual outcome in infants born to drug-misusing mothers prescribed methadone in pregnancy

McGlone, L., Hamilton, R. , McCulloch, D.L., MacKinnon, J.R., Bradnam, M. and Mactier, H. (2014) Visual outcome in infants born to drug-misusing mothers prescribed methadone in pregnancy. British Journal of Ophthalmology, 98(2), pp. 238-245. (doi: 10.1136/bjophthalmol-2013-303967) (PMID:24246372)

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Background Flash visual evoked potentials (VEPs) were abnormal in a cohort of 100 neonates exposed to maintenance methadone in utero. This prospective cohort study now describes clinical visual and electrophysiological outcomes at 6 months.<p></p> Methods Visual assessment included modified Atkinson test battery; strabismus, nystagmus, reduced visual acuity, delayed visual maturation or refractive error (>3 dioptres) defined a fail. Pattern-onset VEPs were recorded to 120′, 60′ and 15′ checks.<p></p> Results 81 drug-exposed and 26 comparison infants (79% and 52% of the original cohorts) were assessed at a median age of 27 weeks (range 26–30). 90% of drug-exposed infants had been additionally exposed to illicit drugs and 41% to excess alcohol in utero. 40% of the drug-exposed cohort failed clinical visual assessment: the relative risk of abnormal assessment was 5.1 (95% CI 1.3 to 20; p=0.02). Nystagmus was particularly common. VEP peak times were slower and amplitudes smaller in drug-exposed infants, of whom 70% had one or more abnormal VEP parameter. Abnormal visual outcome at 6 months was not associated with the pattern of additional drug exposure or a history of neonatal abstinence.<p></p> Conclusions Abnormal visual electrophysiology in infants born to drug-misusing mothers prescribed maintenance methadone persists to 6 months of age, and is associated with abnormal clinical visual assessment.<p></p>

Item Type:Articles
Glasgow Author(s) Enlighten ID:Bradnam, Dr Michael and Hamilton, Dr Ruth
Authors: McGlone, L., Hamilton, R., McCulloch, D.L., MacKinnon, J.R., Bradnam, M., and Mactier, H.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:British Journal of Ophthalmology
Publisher:BMJ Publishing Group
ISSN (Online):1468-2079

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