TY - JOUR
T1 - Maternal buprenorphine treatment and infant outcome
AU - Jansson, Lauren M.
AU - Velez, Martha L.
AU - McConnell, Krystle
AU - Spencer, Nancy
AU - Tuten, Michelle
AU - Jones, Hendree Evelyn
AU - Rios, Rebeca E
AU - King, Van
AU - Gandotra, Neeraj
AU - Millio, Lorraine
AU - DiPietro, Janet A.
N1 - Publisher Copyright:
© 2017
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background and objectives Maternal buprenorphine maintenance predisposes the infant to exhibit neonatal abstinence syndrome (NAS), but there is insufficient published information regarding the nature of NAS and factors that contribute to its severity in buprenorphine-exposed infants. Methods The present study evaluated forty-one infants of buprenorphine-maintained women in comprehensive substance use disorder treatment who participated in an open-label study examining the effects of maternal buprenorphine maintenance on infant outcomes. Modifiers of the infant outcomes, including maternal treatment and substance use disorder parameters, were also evaluated. Results Fifty-nine percent of offspring exhibited NAS that required pharmacologic management. Both maternal buprenorphine dose as well as prenatal polysubstance exposure to illicit substance use/licit substance misuse were independently associated with NAS expression. Polysubstance exposure was associated with more severe NAS expression after controlling for the effects of buprenorphine dose. Other exposures, including cigarette smoking and SRI use, were not related to outcomes. Maternal buprenorphine dose was positively associated with lower birth weight and length. Conclusions Polysubstance exposure was the most potent predictor of NAS severity in this sample of buprenorphine-exposed neonates. This finding suggests the need for interventions that reduce maternal polysubstance use during medication assisted treatment for opioid use disorder, and highlights the necessity of a comprehensive approach, beyond buprenorphine treatment alone, for the optimal care for pregnant women with opioid use disorders.
AB - Background and objectives Maternal buprenorphine maintenance predisposes the infant to exhibit neonatal abstinence syndrome (NAS), but there is insufficient published information regarding the nature of NAS and factors that contribute to its severity in buprenorphine-exposed infants. Methods The present study evaluated forty-one infants of buprenorphine-maintained women in comprehensive substance use disorder treatment who participated in an open-label study examining the effects of maternal buprenorphine maintenance on infant outcomes. Modifiers of the infant outcomes, including maternal treatment and substance use disorder parameters, were also evaluated. Results Fifty-nine percent of offspring exhibited NAS that required pharmacologic management. Both maternal buprenorphine dose as well as prenatal polysubstance exposure to illicit substance use/licit substance misuse were independently associated with NAS expression. Polysubstance exposure was associated with more severe NAS expression after controlling for the effects of buprenorphine dose. Other exposures, including cigarette smoking and SRI use, were not related to outcomes. Maternal buprenorphine dose was positively associated with lower birth weight and length. Conclusions Polysubstance exposure was the most potent predictor of NAS severity in this sample of buprenorphine-exposed neonates. This finding suggests the need for interventions that reduce maternal polysubstance use during medication assisted treatment for opioid use disorder, and highlights the necessity of a comprehensive approach, beyond buprenorphine treatment alone, for the optimal care for pregnant women with opioid use disorders.
KW - Buprenorphine
KW - Maternal opioid use disorder
KW - Medication assisted treatment during pregnancy
KW - Neonatal abstinence syndrome
KW - Opioid exposed neonate
KW - Perinatal substance use disorder treatment
KW - Substance exposed neonate
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U2 - 10.1016/j.drugalcdep.2017.08.001
DO - 10.1016/j.drugalcdep.2017.08.001
M3 - Article
C2 - 28869859
AN - SCOPUS:85033216754
SN - 0376-8716
VL - 180
SP - 56
EP - 61
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
ER -