Treating women with opioid use disorder during pregnancy in Appalachia: Initial neonatal outcomes following buprenorphine + naloxone exposure

Am J Addict. 2018 Mar;27(2):92-96. doi: 10.1111/ajad.12687. Epub 2018 Feb 23.

Abstract

Background and objectives: Rising concerns regarding diversion and misuse of mono-buprenorphine for treatment of pregnant women with opioid use disorders have sparked interest in the use of buprenorphine + naloxone to reduce misuse and diversion rates. Examined the relationship of prenatal buprenorphine + naloxone exposure to neonatal outcomes.

Methods: This is a retrospective chart review of 26 mother infant dyads in comprehensive medication-assisted treatment with buprenorphine + naloxone during pregnancy.

Results: All neonatal birth outcome parameters were within normal ranges, albeit on the lower side of normal for gestational age and birth weight. Only 19% of neonates required morphine pharmacology for NAS.

Conclusions: Use of buprenorphine + naloxone shows relative safety in pregnancy.

Scientific significance: These findings can help better guide prescribing practices for pregnant patients at risk for misuse or diversion of buprenorphine. (Am J Addict 2018;27:92-96).

MeSH terms

  • Adult
  • Appalachian Region / epidemiology
  • Birth Weight / drug effects*
  • Buprenorphine, Naloxone Drug Combination* / adverse effects
  • Buprenorphine, Naloxone Drug Combination* / therapeutic use
  • Female
  • Humans
  • Infant, Newborn
  • Methadone / therapeutic use
  • Neonatal Abstinence Syndrome* / epidemiology
  • Neonatal Abstinence Syndrome* / therapy
  • Opiate Substitution Treatment / methods
  • Opiate Substitution Treatment / statistics & numerical data
  • Opioid-Related Disorders* / drug therapy
  • Opioid-Related Disorders* / epidemiology
  • Opioid-Related Disorders* / psychology
  • Pregnancy
  • Pregnancy Complications* / drug therapy
  • Pregnancy Complications* / epidemiology
  • Pregnancy Complications* / psychology
  • Pregnant Women / psychology
  • Retrospective Studies
  • Risk Adjustment

Substances

  • Buprenorphine, Naloxone Drug Combination
  • Methadone