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Can Fam Physician
Vol. 53, No. 10, October 2007, pp.1722 - 1730
Copyright © 2007 by The College of Family Physicians of Canada
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Research

Rooming-in compared with standard care for newborns of mothers using methadone or heroin

Ronald R. Abrahams, MD CCFP FCFPC
Clinical Professor in the Department of Family Practice at the University of British Columbia in Vancouver and at the Children’s and Women’s Health Centre of British Columbia

S. Ann Kelly, MPH
Research Associate in the Department of Family Practice at the University of British Columbia

Sarah Payne, RN MA
Nurse at the Children’s and Women’s Health Centre of British Columbia

Paul N. Thiessen, MD FRCPC
Clinical Professor in the Department of Pediatrics at the University of British Columbia and at the Children’s and Women’s Health Centre of British Columbia

Jessica Mackintosh
Staff at the Children’s and Women’s Health Centre of British Columbia

Patricia A. Janssen, PhD
Associate Professor in the Department of Family Practice and the Department of Health Care and Epidemiology at the University of British Columbia

Correspondence to: Dr Patricia Janssen, UBC Department of Health Care and Epidemiology, 5804 Fairview Ave, Vancouver, BC V6T 1Z3; telephone 604 875-2424, extension 5415; fax 604 875-3124; e-mail pjanssen{at}interchange.ubc.ca

OBJECTIVE To evaluate the effect of rooming-in (rather than standard nursery care) on the incidence and severity of neonatal abstinence syndrome among opioid-exposed newborns and on the proportion of mothers who retain custody of their babies at hospital discharge.

DESIGN Retrospective cohort study.

SETTING Lower mainland in southwestern British Columbia.

PARTICIPANTS We selected 32 women in the city of Vancouver known to have used heroin or methadone during pregnancy between October 2001 and December 2002. Comparison groups were a historical cohort of 38 women in Vancouver and a concurrent cohort of 36 women cared for in a neighbouring community hospital.

MAIN OUTCOME MEASURES Need for treatment with morphine, number of days of treatment with morphine, and whether babies were discharged in the custody of their mothers.

RESULTS Rooming-in was associated with a significant decrease in need for treatment of neonatal abstinence syndrome compared with the historical cohort (adjusted relative risk [RR] 0.40, 95% confidence interval [CI] 0.20 to 0.78) and the concurrent cohort (adjusted RR 0.39, 95% CI 0.20 to 0.75). Rooming-in was also associated with shorter newborn length of stay in hospital compared with both comparison groups. Newborns who roomed in at BC Women’s Hospital were significantly more likely to be discharged in the custody of their mothers than babies in the historical cohort (RR 2.23, 95% CI 1.43 to 3.98) or the concurrent cohort (RR 1.52, 95% CI 1.15 to 2.53) were.

CONCLUSION Rooming-in might ease opioid-exposed newborns’ transition to extrauterine life and promote more effective mothering.






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