Women maintained on opioid drugs in pregnancy. Investigation of outcomes for mother and child. Evaluation of care and follow up.

Heroin dominated substance abuse is a world wide phenomenon. The dominating treatment approach is opioid maintenance treatment (OMT) based on continuing use of methadone or buprenorphine. As a consequence an increasing number of children is exposed to h igh levels of opioid drugs within uterus and born with opioid dependency. Neonatal abstinence syndrom (NAS) is common but treatable by opioid tapering. Research has so far not found long term negative consequences but international research has several weaknesses. Norwegian OMT (Legemiddelassistert rehabilitation - LAR) is a well developed system with high quality information on womens substance use during pregnancy and on use of maintenance drug. The health care is well established and core registers are of adequate standard. During a pre-program period a national cohort of all women in LAR (1996 - present) is established as well as a sub-cohort cohort of women and children 2005-2006. These are investigated with instruments for mental health, subs tance use and details on birth data and NAS. The children's development the first two years of life are under investigation by a battery of tests aiming at mapping cognitive, emotional and relational factors. The intention is to coordinate this researc h in a comprehensive research program that also includes a test battery for executive and emotional functioning at four years. The methods are compatible with methods used in parallell research at Regional center for child and psychiatry investigating c hildren born by substance abusing women outside of LAR and by women with mental problems without substance abuse. There is also control groups of women without known risk factors. On this basis important unanswered questions pointed out in recent Cochra ne reviews might be answered. The result will have national and international importance and cooperation with core international researcher is established.