Buprenorphine treatment of opioid-dependent pregnant women: A comprehensive review

Hendrée E. Jones, Sarah H. Heil, Andjela Baewert, Amelia M. Arria, Karol Kaltenbach, Peter R. Martin, Mara G. Coyle, Peter Selby, Susan M. Stine, Gabriele Fischer

Research output: Contribution to journalArticle

Abstract

Aims: This paper reviews the published literature regarding outcomes following maternal treatment with buprenorphine in five areas: maternal efficacy, fetal effects, neonatal effects, effects on breast milk and longer-term developmental effects. Methods: Within each outcome area, findings are summarized first for the three randomized clinical trials and then for the 44 non-randomized studies (i.e. prospective studies, case reports and series and retrospective chart reviews), only 28 of which involve independent samples. Results: Results indicate that maternal treatment with buprenorphine has comparable efficacy to methadone, although difficulties may exist with current buprenorphine induction methods. The available fetal data suggest buprenorphine results in less physiological suppression of fetal heart rate and movements than methadone. Regarding neonatal effects, perhaps the single definitive conclusion is that prenatal buprenorphine treatment results in a clinically significant less severe neonatal abstinence syndrome (NAS) than treatment with methadone. The limited research suggests that, like methadone, buprenorphine is compatible with breastfeeding. Data available thus far suggest that there are no deleterious effects of in utero buprenorphine exposure on infant development. Conclusions: While buprenorphine produces a less severe neonatal abstinence syndrome than methadone, both methadone and buprenorphine are important parts of a complete comprehensive treatment approach for opioid-dependent pregnant women.

Original languageEnglish (US)
Pages (from-to)5-27
Number of pages23
JournalAddiction
Volume107
Issue numberSUPPL.1
DOIs
StatePublished - Nov 2012

Fingerprint

Buprenorphine
Opioid Analgesics
Pregnant Women
Methadone
Neonatal Abstinence Syndrome
Therapeutics
Mothers
Fetal Movement
Fetal Heart Rate
Human Milk
Child Development
Breast Feeding
Randomized Controlled Trials
Prospective Studies

Keywords

  • Buprenorphine
  • Opioid dependence
  • Pharmacological treatment
  • Pregnancy

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Psychiatry and Mental health
  • Medicine(all)

Cite this

Jones, H. E., Heil, S. H., Baewert, A., Arria, A. M., Kaltenbach, K., Martin, P. R., ... Fischer, G. (2012). Buprenorphine treatment of opioid-dependent pregnant women: A comprehensive review. Addiction, 107(SUPPL.1), 5-27. https://doi.org/10.1111/j.1360-0443.2012.04035.x

Buprenorphine treatment of opioid-dependent pregnant women : A comprehensive review. / Jones, Hendrée E.; Heil, Sarah H.; Baewert, Andjela; Arria, Amelia M.; Kaltenbach, Karol; Martin, Peter R.; Coyle, Mara G.; Selby, Peter; Stine, Susan M.; Fischer, Gabriele.

In: Addiction, Vol. 107, No. SUPPL.1, 11.2012, p. 5-27.

Research output: Contribution to journalArticle

Jones, HE, Heil, SH, Baewert, A, Arria, AM, Kaltenbach, K, Martin, PR, Coyle, MG, Selby, P, Stine, SM & Fischer, G 2012, 'Buprenorphine treatment of opioid-dependent pregnant women: A comprehensive review', Addiction, vol. 107, no. SUPPL.1, pp. 5-27. https://doi.org/10.1111/j.1360-0443.2012.04035.x
Jones HE, Heil SH, Baewert A, Arria AM, Kaltenbach K, Martin PR et al. Buprenorphine treatment of opioid-dependent pregnant women: A comprehensive review. Addiction. 2012 Nov;107(SUPPL.1):5-27. https://doi.org/10.1111/j.1360-0443.2012.04035.x
Jones, Hendrée E. ; Heil, Sarah H. ; Baewert, Andjela ; Arria, Amelia M. ; Kaltenbach, Karol ; Martin, Peter R. ; Coyle, Mara G. ; Selby, Peter ; Stine, Susan M. ; Fischer, Gabriele. / Buprenorphine treatment of opioid-dependent pregnant women : A comprehensive review. In: Addiction. 2012 ; Vol. 107, No. SUPPL.1. pp. 5-27.
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