Buprenorphine and naloxone compared with methadone treatment in pregnancy

Samantha L. Wiegand, Elizabeth M. Stringer, Alison M. Stuebe, Hendree Jones, Carl Seashore, John Thorp

Research output: Contribution to journalArticle

Abstract

OBJECTIVE:: To compare neonatal abstinence syndrome prevalence and characteristics among neonates born to women prescribed buprenorphine and naloxone compared with methadone during pregnancy. METHODS:: Retrospective cohort analysis of mother-neonate dyads treated with either buprenorphine and naloxone or methadone during pregnancy. Primary neonatal outcomes included diagnosis of neonatal abstinence syndrome, neonatal abstinence syndrome peak scores, total amount of morphine used to treat neonatal abstinence syndrome (mg), and duration of treatment for neonatal abstinence syndrome (days). Secondary outcomes included head circumference, birth weight, length, preterm birth, neonatal intensive care unit admission, Apgar scores, and overall length of hospitalization. RESULTS:: From January 1, 2011, to November 30, 2013, we identified 62 mother-neonate dyads, 31 treated with methadone and 31 treated with buprenorphine and naloxone. Sixteen neonates (51.6%) in the methadone group were diagnosed with neonatal abstinence syndrome compared with eight (25.1%) in the buprenorphine and naloxone group (adjusted odds ratio 2.55, 95% confidence interval [CI] 1.31-4.98, P=.01). The buprenorphine and naloxone-exposed neonates had lower peak neonatal abstinence syndrome scores (9.0±4.4 compared with 10.7±3.7, multivariate-adjusted mean difference=-2.77, 95% CI -4.99 to -0.56, P=.02) and shorter overall hospitalization (5.6±5.0 compared with 9.8±7.4 days, multivariate-adjusted mean difference=-3.90, 95% CI, -7.13 to -0.67, P=.02). We found no other differences in primary or secondary outcomes. CONCLUSION:: In a cohort of pregnant patients treated with either methadone or buprenorphine and naloxone in pregnancy, newborns exposed to maternal buprenorphine and naloxone had less frequent neonatal abstinence syndrome. Additionally, neonates exposed to buprenorphine and naloxone had shorter overall hospitalization lengths.

Original languageEnglish (US)
Pages (from-to)363-368
Number of pages6
JournalObstetrics and Gynecology
Volume125
Issue number2
DOIs
StatePublished - Feb 6 2015
Externally publishedYes

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Neonatal Abstinence Syndrome
Methadone
Pregnancy
Newborn Infant
Hospitalization
Mothers
Confidence Intervals
Therapeutics
Apgar Score
Naloxone Drug Combination Buprenorphine
Neonatal Intensive Care Units
Premature Birth
Birth Weight
Morphine
Cohort Studies
Odds Ratio
Head

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Wiegand, S. L., Stringer, E. M., Stuebe, A. M., Jones, H., Seashore, C., & Thorp, J. (2015). Buprenorphine and naloxone compared with methadone treatment in pregnancy. Obstetrics and Gynecology, 125(2), 363-368. https://doi.org/10.1097/AOG.0000000000000640

Buprenorphine and naloxone compared with methadone treatment in pregnancy. / Wiegand, Samantha L.; Stringer, Elizabeth M.; Stuebe, Alison M.; Jones, Hendree; Seashore, Carl; Thorp, John.

In: Obstetrics and Gynecology, Vol. 125, No. 2, 06.02.2015, p. 363-368.

Research output: Contribution to journalArticle

Wiegand, SL, Stringer, EM, Stuebe, AM, Jones, H, Seashore, C & Thorp, J 2015, 'Buprenorphine and naloxone compared with methadone treatment in pregnancy', Obstetrics and Gynecology, vol. 125, no. 2, pp. 363-368. https://doi.org/10.1097/AOG.0000000000000640
Wiegand SL, Stringer EM, Stuebe AM, Jones H, Seashore C, Thorp J. Buprenorphine and naloxone compared with methadone treatment in pregnancy. Obstetrics and Gynecology. 2015 Feb 6;125(2):363-368. https://doi.org/10.1097/AOG.0000000000000640
Wiegand, Samantha L. ; Stringer, Elizabeth M. ; Stuebe, Alison M. ; Jones, Hendree ; Seashore, Carl ; Thorp, John. / Buprenorphine and naloxone compared with methadone treatment in pregnancy. In: Obstetrics and Gynecology. 2015 ; Vol. 125, No. 2. pp. 363-368.
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abstract = "OBJECTIVE:: To compare neonatal abstinence syndrome prevalence and characteristics among neonates born to women prescribed buprenorphine and naloxone compared with methadone during pregnancy. METHODS:: Retrospective cohort analysis of mother-neonate dyads treated with either buprenorphine and naloxone or methadone during pregnancy. Primary neonatal outcomes included diagnosis of neonatal abstinence syndrome, neonatal abstinence syndrome peak scores, total amount of morphine used to treat neonatal abstinence syndrome (mg), and duration of treatment for neonatal abstinence syndrome (days). Secondary outcomes included head circumference, birth weight, length, preterm birth, neonatal intensive care unit admission, Apgar scores, and overall length of hospitalization. RESULTS:: From January 1, 2011, to November 30, 2013, we identified 62 mother-neonate dyads, 31 treated with methadone and 31 treated with buprenorphine and naloxone. Sixteen neonates (51.6{\%}) in the methadone group were diagnosed with neonatal abstinence syndrome compared with eight (25.1{\%}) in the buprenorphine and naloxone group (adjusted odds ratio 2.55, 95{\%} confidence interval [CI] 1.31-4.98, P=.01). The buprenorphine and naloxone-exposed neonates had lower peak neonatal abstinence syndrome scores (9.0±4.4 compared with 10.7±3.7, multivariate-adjusted mean difference=-2.77, 95{\%} CI -4.99 to -0.56, P=.02) and shorter overall hospitalization (5.6±5.0 compared with 9.8±7.4 days, multivariate-adjusted mean difference=-3.90, 95{\%} CI, -7.13 to -0.67, P=.02). We found no other differences in primary or secondary outcomes. CONCLUSION:: In a cohort of pregnant patients treated with either methadone or buprenorphine and naloxone in pregnancy, newborns exposed to maternal buprenorphine and naloxone had less frequent neonatal abstinence syndrome. Additionally, neonates exposed to buprenorphine and naloxone had shorter overall hospitalization lengths.",
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AU - Thorp, John

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N2 - OBJECTIVE:: To compare neonatal abstinence syndrome prevalence and characteristics among neonates born to women prescribed buprenorphine and naloxone compared with methadone during pregnancy. METHODS:: Retrospective cohort analysis of mother-neonate dyads treated with either buprenorphine and naloxone or methadone during pregnancy. Primary neonatal outcomes included diagnosis of neonatal abstinence syndrome, neonatal abstinence syndrome peak scores, total amount of morphine used to treat neonatal abstinence syndrome (mg), and duration of treatment for neonatal abstinence syndrome (days). Secondary outcomes included head circumference, birth weight, length, preterm birth, neonatal intensive care unit admission, Apgar scores, and overall length of hospitalization. RESULTS:: From January 1, 2011, to November 30, 2013, we identified 62 mother-neonate dyads, 31 treated with methadone and 31 treated with buprenorphine and naloxone. Sixteen neonates (51.6%) in the methadone group were diagnosed with neonatal abstinence syndrome compared with eight (25.1%) in the buprenorphine and naloxone group (adjusted odds ratio 2.55, 95% confidence interval [CI] 1.31-4.98, P=.01). The buprenorphine and naloxone-exposed neonates had lower peak neonatal abstinence syndrome scores (9.0±4.4 compared with 10.7±3.7, multivariate-adjusted mean difference=-2.77, 95% CI -4.99 to -0.56, P=.02) and shorter overall hospitalization (5.6±5.0 compared with 9.8±7.4 days, multivariate-adjusted mean difference=-3.90, 95% CI, -7.13 to -0.67, P=.02). We found no other differences in primary or secondary outcomes. CONCLUSION:: In a cohort of pregnant patients treated with either methadone or buprenorphine and naloxone in pregnancy, newborns exposed to maternal buprenorphine and naloxone had less frequent neonatal abstinence syndrome. Additionally, neonates exposed to buprenorphine and naloxone had shorter overall hospitalization lengths.

AB - OBJECTIVE:: To compare neonatal abstinence syndrome prevalence and characteristics among neonates born to women prescribed buprenorphine and naloxone compared with methadone during pregnancy. METHODS:: Retrospective cohort analysis of mother-neonate dyads treated with either buprenorphine and naloxone or methadone during pregnancy. Primary neonatal outcomes included diagnosis of neonatal abstinence syndrome, neonatal abstinence syndrome peak scores, total amount of morphine used to treat neonatal abstinence syndrome (mg), and duration of treatment for neonatal abstinence syndrome (days). Secondary outcomes included head circumference, birth weight, length, preterm birth, neonatal intensive care unit admission, Apgar scores, and overall length of hospitalization. RESULTS:: From January 1, 2011, to November 30, 2013, we identified 62 mother-neonate dyads, 31 treated with methadone and 31 treated with buprenorphine and naloxone. Sixteen neonates (51.6%) in the methadone group were diagnosed with neonatal abstinence syndrome compared with eight (25.1%) in the buprenorphine and naloxone group (adjusted odds ratio 2.55, 95% confidence interval [CI] 1.31-4.98, P=.01). The buprenorphine and naloxone-exposed neonates had lower peak neonatal abstinence syndrome scores (9.0±4.4 compared with 10.7±3.7, multivariate-adjusted mean difference=-2.77, 95% CI -4.99 to -0.56, P=.02) and shorter overall hospitalization (5.6±5.0 compared with 9.8±7.4 days, multivariate-adjusted mean difference=-3.90, 95% CI, -7.13 to -0.67, P=.02). We found no other differences in primary or secondary outcomes. CONCLUSION:: In a cohort of pregnant patients treated with either methadone or buprenorphine and naloxone in pregnancy, newborns exposed to maternal buprenorphine and naloxone had less frequent neonatal abstinence syndrome. Additionally, neonates exposed to buprenorphine and naloxone had shorter overall hospitalization lengths.

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