Abstract
Aim: To determine the effects of in utero exposure to methadone or buprenorphine on infant neurobehavior. Design: Three sites from the Maternal Opioid Treatment: Human Experimental Research (MOTHER) study, a double-blind, double-dummy, randomized clinical trial participated in this substudy. Setting: Medical Centers that provided comprehensive maternal care to opioid-dependent pregnant women in Baltimore, MD, Providence, RI and Vienna, Austria. Participants: Thirty-nine full-term infants. Measurements: The Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale (NNNS) was administered to a subgroup of infants on postpartum days 3, 5, 7, 10, 14-15 and 28-30. Findings: While neurobehavior improved for both medication conditions over time, infants exposed in utero to buprenorphine exhibited fewer stress-abstinence signs (P<0.001), were less excitable (P<0.001) and less over-aroused (P<0.01), exhibited less hypertonia (P<0.007), had better self-regulation (P<0.04) and required less handling (P<0.001) to maintain a quiet alert state relative to in utero methadone-exposed infants. Infants who were older when they began morphine treatment for withdrawal had higher self-regulation scores (P<0.01), and demonstrated the least amount of excitability (P<0.02) and hypertonia (P<0.02) on average. Quality of movement was correlated negatively with peak NAS score (P<0.01), number of days treated with morphine for NAS (P<0.01) and total amount of morphine received (P<0.03). Excitability scores were related positively to total morphine dose (P<0.03). Conclusion: While neurobehavior improves during the first month of postnatal life for in utero agonist medication-exposed neonates, buprenorphine exposure results in superior neurobehavioral scores and less severe withdrawal than does methadone exposure.
Original language | English (US) |
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Pages (from-to) | 63-73 |
Number of pages | 11 |
Journal | Addiction |
Volume | 107 |
Issue number | SUPPL.1 |
DOIs | |
State | Published - Nov 2012 |
Externally published | Yes |
Keywords
- Full-term infant
- NICU Network Neurobehavioral Scale (NNNS)
- Neonatal abstinence syndrome
- Neurobehavior
- Opioid exposed newborn
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Psychiatry and Mental health