%0 Journal Article
%T The impact of cocaine and heroin on the placental transfer of methadone
%A Antoine Malek
%A Cristina Obrist
%A Silvana Wenzinger
%A Ursula von Mandach
%J Reproductive Biology and Endocrinology
%D 2009
%I BioMed Central
%R 10.1186/1477-7827-7-61
%X Placentae (n = 24) were ex-vivo perfused with medium (m) (control, n = 6), m plus methadone (n = 6), m plus methadone and cocaine (n = 6) or m plus methadone and heroin (n = 6). Placental functionality parameters like antipyrine permeability, glucose consumption, lactate production, hormone production (hCG and leptin), microparticles release and the expression of P-glycoprotein were analysed.Methadone accumulated in placental tissue. Methadone alone decreased the transfer of antipyrine from 0.60 +/- 0.07 to 0.50 +/- 0.06 (fetal/maternal ratio, mean +/- SD, P < 0.01), whereas the combination with cocaine or heroin increased it (0.56 +/- 0.08 to 0.68 +/- 0.13, P = 0.03 and 0.58 +/- 0.21 to 0.71 +/- 0.24; P = 0.18). Microparticles (MPs) released from syncytiotrophoblast into maternal circuit increased by 30% after cocaine or heroin (P < 0.05) and the expression of P-glycoprotein in the tissue increased by ¡Ý 49% after any drug (P < 0.05). All other measured parameters did not show any significant effect when methadone was combined with cocaine or heroine.The combination of cocaine or heroin with methadone increase antipyrine permeability. Changes of MPs resemble findings seen in oxidative stress of syncytiotrophoblast.In developed countries an increase in substance abuse in pregnancy can be observed. Opiates cross the placenta easily and lead to intrauterine growth restriction (IUGR), preterm birth and spontaneous abortion [1-4]. Abstinence cannot be achieved in most of the patients and methadone is the recommended standard of care for pregnant opioid-dependent women [5]. The positive effects of methadone are an increase in birth weight and the prolongation of gestation [4,6]. In addition, women in a maintenance therapy program receive more prenatal care which improves the situation for both, mother and fetus. However, the main disadvantage of this therapy is the neonatal abstinence syndrome (NAS) which occurs in 60¨C80% of the newborns from mothers who consumed methadon
%U http://www.rbej.com/content/7/1/61