Buprenorphine for Medication-Assisted Treatment of Opioid Use Disorder in Pregnancy: Relationship to Neonatal Opioid Withdrawal Syndrome

Niraj R. Chavan; Kristin B. Ashford; Amanda T. Wiggins; Michelle R. Lofwall; Agatha S. Critchfield

doi:10.1055/s-0037-1608783

American Journal of Perinatology Reports, Table of Contents

CC-BY-NC-ND 4.0 · AJP Rep 2017; 07(04): e215-e222
DOI: 10.1055/s-0037-1608783

Case Report

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Buprenorphine for Medication-Assisted Treatment of Opioid Use Disorder in Pregnancy: Relationship to Neonatal Opioid Withdrawal Syndrome

Authors

Niraj R. Chavan

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky
Kristin B. Ashford

²University of Kentucky College of Nursing, Lexington, Kentucky
Amanda T. Wiggins

²University of Kentucky College of Nursing, Lexington, Kentucky
Michelle R. Lofwall

³Department of Behavioral Science and Psychiatry, Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington, Kentucky
Agatha S. Critchfield

¹Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington, Kentucky

Abstract

Objective To examine the relationship between antepartum buprenorphine dose for medication-assisted treatment (MAT) of opioid use disorder (OUD) and incident neonatal opioid withdrawal syndrome (NOWS).

Study Design We performed a prospective cohort study of pregnant women with a singleton gestation diagnosed with OUD and receiving buprenorphine for MAT at a tertiary care academic institution from July 2015 to January 2017. We divided the study cohort into two groups—pregnancies with versus without NOWS. Substance abuse patterns in pregnancy, maternal, and neonatal clinical outcomes were compared.

Results The incidence of NOWS was 31.11% (n = 28/90) in our study cohort. Pregnancies with NOWS had a significantly higher rate of benzodiazepine positive urine tests and number of positive urine drug screen (UDS) results for illicit opioids. The group without NOWS had significantly higher number of patients with an appropriate UDS result at delivery through postpartum. Rates of neonatal intensive care unit (NICU) admission, length of NICU stay, and maximum Finnegan score were significantly higher in the group with NOWS. Neither the initial (10.6 ± 5.2 versus 10.3 ± 4.8 mg, p = 0.80) nor the final buprenorphine doses (13.3 ± 5.1 versus 13.0 ± 4.6 mg, p = 0.81) were significantly different between study groups.

Conclusion The occurrence of NOWS was not related to buprenorphine dose used for MAT.

Keywords

buprenorphine - opioid use disorder (OUD) - medication assisted treatment (MAT) - neonatal opioid withdrawal syndrome (NOWS)

Full Text

References

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