Treatment of opioid‐dependent pregnant women with buprenorphine

Abstract

Buprenorphine appears to be well accepted by mother and fetus, and associated with a low incidence of NAS. Further investigation of buprenorphine as a maintenance agent for opioid-dependent pregnant women is needed.

Observational Study of Buprenorphine Treatment of Opioid-Dependent Pregnant Women in a Family Medicine Residency: Reports on Maternal and Infant Outcomes

“…14,17,18 The mean birth weight of infants in this series was 3148 g, which is in the range of previously reported data (2796, 2843, 3000, 3049, and 3180 g). 3,[15][16][17][18] Similarly, the mean gestational age of infants was 39.3 weeks compared with 38.4 weeks, 38.8 weeks, and 39.6 weeks, which have been reported previously. 3,16,18 The mean time to first peak NAS score for all infants in this case series was 66.2 hours, which is similar to existing data.…”

“…3,[15][16][17][18] Similarly, the mean gestational age of infants was 39.3 weeks compared with 38.4 weeks, 38.8 weeks, and 39.6 weeks, which have been reported previously. 3,16,18 The mean time to first peak NAS score for all infants in this case series was 66.2 hours, which is similar to existing data. 14,18 Thirty-five percent of infants (8 of 23) required treatment for NAS, which is within the range of previous studies (14.9%, 25.8%, 52%, 57%, 62.5%, and 76.9%).…”

“…16 There was no difference between the mean maternal buprenorphine dose among infants who required treatment for NAS (12.1 mg) and infants who did not require treatment (13.9 mg), which has been previously reported. 3 No significant difference was found in the NAS severity of infants born to mothers who were taking buprenorphine before pregnancy (33% of infants who were treated for NAS) and infants born to mothers who initiated treatment during the course of their pregnancy (35% of infants who required treatment). This does not support the findings of other authors who reported that, when buprenorphine treatment is initiated before conception, NAS is significantly less frequent than in opioid-dependent women who initiate treatment after conception (26% of infants compared with 60%, respectively).…”

“…The use of prescribed buprenorphine at regular intervals reduces the variability of the maternal serum opioid levels that accompany recurrent use of short-acting opioids, thereby reducing intrauterine fetal withdrawal. 3 The maternal-fetal effects of opioid dependence during pregnancy range from no anomalies or adverse outcomes to intrauterine growth restriction, placental insufficiency, preeclampsia, preterm rupture of membranes, premature delivery, postpartum hemorrhage, and perinatal mortality. 1,4 Fetal withdrawal from opioids in nonhuman subjects is associated with increased morbidity and mortality, likely because of reduced intrauterine and placental blood flow and diminished availability of oxygen to the fetus.…”

Substitutionstherapie und (psycho-)soziale Betreuung von opiatabhängigen Schwangeren. Aventis Early Morning Symposium, 13. Kongress der DGS, Berlin, 6.11.2004

“…Buprenorphin führt im Vergleich zu Methadon und L-Polamidon seltener zu einem Neugeborenen-Entzugssyndrom, das zudem in der Regel noch geringer ausgeprägt ist; es wird als Substitutionsmedikament jedoch nicht von allen Patientinnen akzeptiert [2,3]. In Abb.…”