Neonatal outcomes and their relationship to maternal buprenorphine dose during
pregnancy.
Author(s): Jones HE(1), Dengler E(2), Garrison A(3), O'Grady KE(4), Seashore C(5), Horton
E(6), Andringa K(6), Jansson LM(7), Thorp J(6).
Affiliation(s): Author information:
(1)UNC Horizons and Department of Obstetrics and Gynecology, University of North
Carolina at Chapel Hill, Carrboro, NC 27510, USA; Departments of Psychiatry and
Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns
Hopkins University, Baltimore, MD 21224, USA. Electronic address:
hendree_jones@med.unc.edu.
(2)Department of Neuroscience, Washington and Lee University, Lexington, VA 24450,
USA.
(3)Department of Sociology, University of North Carolina at Chapel Hill, Chapel
Hill, NC 27514, USA.
(4)Department of Psychology, University of Maryland, College Park, College Park, MD
20742, USA.
(5)Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel
Hill, NC 27514, USA.
(6)UNC Horizons and Department of Obstetrics and Gynecology, University of North
Carolina at Chapel Hill, Carrboro, NC 27510, USA.
(7)Department of Pediatrics, School of Medicine, Johns Hopkins University,
Baltimore, MD 21224, USA.
Publication date & source: 2014, Drug Alcohol Depend. , 134:414-7
BACKGROUND: Buprenorphine pharmacotherapy for opioid-dependent pregnant women is
associated with maternal and neonatal outcomes superior to untreated opioid
dependence. However, the literature is inconsistent regarding the possible
existence of a dose-response relationship between maternal buprenorphine dose and
neonatal clinical outcomes.
METHODS: The present secondary analysis study (1) examined the relationship
between maternal buprenorphine dose at delivery and neonatal abstinence syndrome
(NAS) peak score, estimated gestational age at delivery, Apgar scores at 1 and 5
min, neonatal head circumference, length, and weight at birth, amount of morphine
needed to treat NAS, duration of NAS treatment, and duration of neonatal hospital
stay and (2) compared neonates who required pharmacotherapy for NAS to neonates
who did not require such pharmacotherapy on these same outcomes, in 58
opioid-dependent pregnant women receiving buprenorphine as participants in a
randomized clinical trial.
RESULTS: (1) Analyses failed to provide evidence of a relationship between
maternal buprenorphine dose at delivery and any of the 10 outcomes (all
p-values>.48) and (2) significant mean differences between the untreated (n=31)
and treated (n=27) for NAS groups were found for duration of neonatal hospital
stay and NAS peak score (both p-values<.001).
CONCLUSIONS: (1) Findings failed to support the existence of a dose-response
relationship between maternal buprenorphine dose at delivery and any of 10
neonatal clinical outcomes, including NAS severity and (2) that infants treated
for NAS had a higher mean NAS peak score and, spent a longer time in the hospital
than did the group not treated for NAS is unsurprising.
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