Neonatal outcomes and their relationship to maternal buprenorphine dose during pregnancy

Hendrée E Jones¹, Erin Dengler², Anna Garrison³, Kevin E O'Grady⁴, Carl Seashore⁵, Evette Horton⁶, Kim Andringa⁶, Lauren M Jansson⁷, John Thorp⁶

Affiliations

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.

PMID: 24290979
PMCID: PMC4117648
DOI: 10.1016/j.drugalcdep.2013.11.006

Randomized Controlled Trial

Neonatal outcomes and their relationship to maternal buprenorphine dose during pregnancy

Hendrée E Jones et al. Drug Alcohol Depend. 2014.

. 2014 Jan 1:134:414-417.

doi: 10.1016/j.drugalcdep.2013.11.006. Epub 2013 Nov 16.

Authors

Hendrée E Jones¹, Erin Dengler², Anna Garrison³, Kevin E O'Grady⁴, Carl Seashore⁵, Evette Horton⁶, Kim Andringa⁶, Lauren M Jansson⁷, John Thorp⁶

Affiliations

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.

PMID: 24290979
PMCID: PMC4117648
DOI: 10.1016/j.drugalcdep.2013.11.006

Abstract

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.

Keywords: Buprenorphine; Neonatal abstinence syndrome; Neonate; Opioid use disorder; Pregnancy.

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References

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Neonatal outcomes and their relationship to maternal buprenorphine dose during pregnancy

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Neonatal outcomes and their relationship to maternal buprenorphine dose during pregnancy

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