TY - JOUR
KW - Adult
KW - Buprenorphine/adverse effects
KW - Female
KW - Humans
KW - Infant, Newborn
KW - Methadone/adverse effects
KW - Naloxone/adverse effects
KW - Narcotic Antagonists/adverse effects
KW - Narcotics/adverse effects
KW - Neonatal Abstinence Syndrome/prevention & control
KW - Opiate Substitution Treatment/adverse effects
KW - Opioid-Related Disorders/drug therapy
KW - Pregnancy
KW - Pregnancy Complications/drug therapy
KW - Retrospective Studies
KW - Young Adult
AU - S. L. Wiegand
AU - E. M. Stringer
AU - A. M. Stuebe
AU - H. Jones
AU - C. Seashore
AU - J. Thorp
A1 - 
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.
BT - Obstetrics and gynecology
C5 - Opioids & Substance Use; Healthcare Disparities
CP - 2
CY - United States
DO - 10.1097/AOG.0000000000000640
IS - 2
JF - Obstetrics and gynecology
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.
PP - United States
PY - 2015
SN - 1873-233X; 0029-7844
SP - 363
EP - 368
EP - 
T1 - Buprenorphine and naloxone compared with methadone treatment in pregnancy
T2 - Obstetrics and gynecology
TI - Buprenorphine and naloxone compared with methadone treatment in pregnancy
U1 - Opioids & Substance Use; Healthcare Disparities
U2 - 25569005
U3 - 10.1097/AOG.0000000000000640
VL - 125
VO - 1873-233X; 0029-7844
Y1 - 2015
ER -