Disadvantages of maternal methadone maintenance during pregnancy include which neonatal outcome?

• A. Increased fetal growth
• B. Prolonged course of NAS
• C. Decreased abstinence symptoms
• D. Shorter NAS

Answer: (B)

The key idea is that giving methadone to a pregnant person can lead to neonatal abstinence syndrome in the newborn, and the long-acting nature of methadone means withdrawal symptoms tend to persist longer after birth. Because methadone has a long half-life, the fetus remains exposed and dependent even as birth occurs, so after birth the drug clears slowly and withdrawal symptoms can continue for an extended period. This results in a prolonged course of NAS that often requires longer treatment and hospital care for the infant.

Other options don’t fit as well. Methadone exposure isn’t associated with increased fetal growth; if anything, growth restriction or normal growth with other risks is more typical. NAS symptoms occur with methadone exposure and may last longer rather than shorter, so a shorter NAS is unlikely.