TY - JOUR
KW - Administration, Oral
KW - Administration, Sublingual
KW - Buprenorphine/administration & dosage/therapeutic use
KW - Drug Implants
KW - Female
KW - Humans
KW - Methadone/administration & dosage/therapeutic use
KW - Naltrexone/administration & dosage/therapeutic use
KW - Narcotic Antagonists/administration & dosage/therapeutic use
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy/metabolism
KW - Pregnancy
KW - Pregnancy Complications/drug therapy
KW - Pregnancy Outcome
KW - Retrospective Studies
AU - E. Kelty
AU - G. Hulse
A1 - 
AB - BACKGROUND: Opioid pharmacotherapies play an important role in the treatment of opioid-dependent women; however, very little is known about the safety of naltrexone in pregnant patients. OBJECTIVE: This study examined the obstetric health of opioid-dependent women who were treated with implant naltrexone during pregnancy, and compared them with women treated with methadone and/or buprenorphine and a cohort of non-opioid-dependent controls. METHODS: Women treated with implant naltrexone, oral methadone or sublingual buprenorphine between 2001 and 2010, along with a cohort of age-matched controls, were linked with records from midwives, hospital and emergency departments (EDs) and the death registry to identify pregnancy and health events that occurred during pregnancy and in the post-partum period. RESULTS: Overall rates of pregnancy loss (requiring hospital or ED attendance) were significantly elevated in naltrexone-treated women compared with buprenorphine-treated women (p = 0.018) and controls (p < 0.001); however, they were not statistically different to methadone-treated women (p = 0.210). Birth rates in women on naltrexone implant treatment were significantly higher than in all three comparison groups (p < 0.001). Rates of hospital and ED attendance during pregnancy in the naltrexone-treated women were not statistically different to those of either the methadone or buprenorphine groups, and neither were overall complications during pregnancy and labour. Overall rates of complications during pregnancy were significantly higher in the naltrexone-treated women than in the controls. CONCLUSION: Opioid-dependent women treated with naltrexone implant had higher rates of birth than the other three groups (methadone- or buprenorphine-treated women, or age-matched controls). Overall rates of complications during pregnancy were elevated in naltrexone-treated women when compared with the control group, but were generally not significantly different to rates in methadone- or buprenorphine-treated women.
AD - School of Psychiatry and Clinical Neuroscience, University of Western Australia, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia. erin.kelty@uwa.edu.au.; School of Population and Global Health, University of Western Australia, Crawley, WA, 6009, Australia. erin.kelty@uwa.edu.au.; School of Psychiatry and Clinical Neuroscience, University of Western Australia, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia.
BT - Drugs
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 11
CY - New Zealand
DO - 10.1007/s40265-017-0762-9
IS - 11
JF - Drugs
M1 - Journal Article
N2 - BACKGROUND: Opioid pharmacotherapies play an important role in the treatment of opioid-dependent women; however, very little is known about the safety of naltrexone in pregnant patients. OBJECTIVE: This study examined the obstetric health of opioid-dependent women who were treated with implant naltrexone during pregnancy, and compared them with women treated with methadone and/or buprenorphine and a cohort of non-opioid-dependent controls. METHODS: Women treated with implant naltrexone, oral methadone or sublingual buprenorphine between 2001 and 2010, along with a cohort of age-matched controls, were linked with records from midwives, hospital and emergency departments (EDs) and the death registry to identify pregnancy and health events that occurred during pregnancy and in the post-partum period. RESULTS: Overall rates of pregnancy loss (requiring hospital or ED attendance) were significantly elevated in naltrexone-treated women compared with buprenorphine-treated women (p = 0.018) and controls (p < 0.001); however, they were not statistically different to methadone-treated women (p = 0.210). Birth rates in women on naltrexone implant treatment were significantly higher than in all three comparison groups (p < 0.001). Rates of hospital and ED attendance during pregnancy in the naltrexone-treated women were not statistically different to those of either the methadone or buprenorphine groups, and neither were overall complications during pregnancy and labour. Overall rates of complications during pregnancy were significantly higher in the naltrexone-treated women than in the controls. CONCLUSION: Opioid-dependent women treated with naltrexone implant had higher rates of birth than the other three groups (methadone- or buprenorphine-treated women, or age-matched controls). Overall rates of complications during pregnancy were elevated in naltrexone-treated women when compared with the control group, but were generally not significantly different to rates in methadone- or buprenorphine-treated women.
PP - New Zealand
PY - 2017
SN - 1179-1950; 0012-6667
SP - 1199
EP - 1210
EP - 
T1 - A Retrospective Cohort Study of Obstetric Outcomes in Opioid-Dependent Women Treated with Implant Naltrexone, Oral Methadone or Sublingual Buprenorphine, and Non-Dependent Controls
T2 - Drugs
TI - A Retrospective Cohort Study of Obstetric Outcomes in Opioid-Dependent Women Treated with Implant Naltrexone, Oral Methadone or Sublingual Buprenorphine, and Non-Dependent Controls
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 28536980
U3 - 10.1007/s40265-017-0762-9
VL - 77
VO - 1179-1950; 0012-6667
Y1 - 2017
Y2 - Jul
ER -