The effects of prenatal exposure to buprenorphine or methadone on infant visual evoked potentials

Whitham, Justine N.; Spurrier, Nicola; Sawyer, Michael; Baghurst, Peter; Taplin, John E.; White, Jason M.; Gordon, Andrea

doi:10.1016/j.ntt.2009.09.001

Cited by 49 publications

(51 citation statements)

References 50 publications

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“…In two RCTs 19, 21, BUP‐exposed newborns' heads averaged 0.90 cm larger than MET‐exposed newborns. In five OBSs 39, 42, 43, 48, 49, mean head circumference was 0.68 cm larger in BUP‐ than MET‐exposed infants (Table 2 and Fig. 4b).…”

Section: Resultsmentioning

confidence: 95%

“…Of 1111 citations identified, 140 full‐text papers were assessed for eligibility, and 18 studies 18, 19, 20, 21, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 (reported in 23 papers 18, 19, 20, 21, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52) satisfied our inclusion criteria (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…The only three RCTs 19, 20, 21 (six papers 19, 20, 21, 50, 51, 52) that have been conducted to date were included (223 participants; published 2005–10) (Supporting information, Table S2). Fifteen OBSs 18, 34, 35, 36, 37, 38, 39, 41, 42, 43, 44, 45, 46, 47, 48 (17 papers) 18, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49 enrolled a total of 1923 participants in prospective 18, 34, 35, 36, 37, 38, 39, 41, 42, 45, 46, 47 ( n = 12) or retrospective 43, 44, 48 ( n = 3) cohort studies published 2001–15. No case–control studies were identified.…”

Section: Resultsmentioning

confidence: 99%

“…Statistical heterogeneity was low among the main analyses except for growth outcomes [birth weight (two RCTs, I 2 = 50%); LBW (two OBSs, I 2 = 62%); and SGA (two OBSs, I 2 = 50%)]. ROB was rated medium for each RCT ( n = 3, Supporting information, Table S3) and medium ( n = 9) 18, 38, 39, 40, 41, 42, 43, 48, 49 or high ( n = 8) 34, 35, 36, 37, 44, 45, 46, 47 for all OBSs (Supporting information, Table S4). Twelve OBSs assessed the balance between treatment groups for various confounding factors at study enrollment (Supporting information, Table S2), but only two OBSs adjusted for confounding factors in estimating treatment effects 39, 48.…”

Section: Resultsmentioning

confidence: 99%

“…Preterm births in the studies included in the birth weight meta‐analysis ranged from 0 to 19% in the two RCTs (0 and 7% for BUP; 9 and 19% for MET) and 4–19% among the five OBSs (4–19% for BUP; 8–17% for MET). One OBS excluded preterm births from the birth weight analysis 49.…”

Section: Resultsmentioning

confidence: 99%

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Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta‐analysis of safety in the mother, fetus and child

et al. 2016

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AimsTo assess the safety of buprenorphine compared with methadone to treat pregnant women with opioid use disorder.MethodsWe searched PubMed, Embase and the Cochrane Library from inception to February 2015 for randomized controlled trials (RCT) and observational cohort studies (OBS) that compared buprenorphine with methadone for treating opioid‐dependent pregnant women. Two reviewers assessed independently the titles and abstracts of all search results and full texts of potentially eligible studies reporting original data for maternal/fetal/infant death, preterm birth, fetal growth outcomes, fetal/congenital anomalies, fetal/child neurodevelopment and/or maternal adverse events. We ascertained each study's risk of bias using validated instruments and assessed the strength of evidence for each outcome using established methods. We computed effect sizes using random‐effects models for each outcome with two or more studies.ResultsThree RCTs (n = 223) and 15 cohort OBSs (n = 1923) met inclusion criteria. In meta‐analyses using unadjusted data and methadone as comparator, buprenorphine was associated with lower risk of preterm birth [RCT risk ratio (RR) = 0.40, 95% confidence interval (CI) = 0.18, 0.91; OBS RR = 0.67, 95% CI = 0.50, 0.90], greater birth weight [RCT weighted mean difference (WMD) = 277 g, 95% CI = 104, 450; OBS WMD = 265 g, 95% CI = 196, 335] and larger head circumference [RCT WMD = 0.90 cm, 95% CI = 0.14, 1.66; OBS WMD = 0.68 cm, 95% CI = 0.41, 0.94]. No treatment differences were observed for spontaneous fetal death, fetal/congenital anomalies and other fetal growth measures, although the power to detect such differences may be inadequate due to small sample sizes.ConclusionsModerately strong evidence indicates lower risk of preterm birth, greater birth weight and larger head circumference with buprenorphine treatment of maternal opioid use disorder during pregnancy compared with methadone treatment, and no greater harms.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta‐analysis of safety in the mother, fetus and child

et al. 2016

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Cognitive Outcomes of Young Children After Prenatal Exposure to Medications for Opioid Use Disorder

et al. 2020

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IMPORTANCE The number of children with prenatal opioid exposure to medication for addiction treatment (MAT) with methadone and buprenorphine for maternal opioid use disorder is increasing, but the associations of this exposure with cognitive outcomes are not well understood. OBJECTIVE To examine the strength and consistency of findings in the medical literature regarding the association of prenatal exposure to MAT with early childhood cognitive development, particularly when accounting for variables outside MAT exposure.

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Buprenorphine Use in Pregnant Opioid Users: A Critical Review

Soyka

2013

CNS Drugs

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Pregnancy in opioid users poses a number of problems to treating physicians. Most guidelines recommend maintenance treatment to manage opioid addiction in pregnancy, with methadone being the gold standard. More recently, buprenorphine has been discussed as an alternate medication. The use and efficacy of buprenorphine in pregnancy is still controversial. This article reviews the current database on the basis of a detailed and critical literature search performed in MEDLINE (206 counts). Most of the relevant studies (randomised clinical trials and one national cohort sample) were published in the last 2 years and mainly compared buprenorphine with methadone. Some studies are related to maternal outcomes, others to foetal, neonatal or older child outcomes. With respect to maternal outcomes, most studies suggest that buprenorphine has similar effects to methadone. Very few data from small studies discuss an effect of buprenorphine on neurodevelopment of the foetus. Neonatal abstinence syndrome is common in infants of both buprenorphine- and methadone-maintained mothers. As regards neonatal outcomes, buprenorphine has the same clinical outcome as methadone, although some newer studies suggest that it causes fewer withdrawal symptoms. Since hardly any studies have investigated the combination of buprenorphine with naloxone (which has been suggested to possibly have teratogenic effects) in pregnant women, a switch to buprenorphine monotherapy is recommended in women who become pregnant while receiving the combination product. These novel findings indicate that buprenorphine is emerging as a first-line treatment for pregnant opioid users.

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The effects of prenatal exposure to buprenorphine or methadone on infant visual evoked potentials

Cited by 49 publications

References 50 publications

Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta‐analysis of safety in the mother, fetus and child

Buprenorphine compared with methadone to treat pregnant women with opioid use disorder: a systematic review and meta‐analysis of safety in the mother, fetus and child

Cognitive Outcomes of Young Children After Prenatal Exposure to Medications for Opioid Use Disorder

Buprenorphine Use in Pregnant Opioid Users: A Critical Review

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