Buprenorphine and Naloxone Versus Buprenorphine for Opioid Use Disorder in Pregnancy: A Cohort Study.
Analgesics, Opioid
/ administration & dosage
Buprenorphine
/ administration & dosage
Drug Combinations
Female
Humans
Infant, Newborn
Male
Naloxone
/ administration & dosage
Neonatal Abstinence Syndrome
/ drug therapy
Opiate Substitution Treatment
Opioid-Related Disorders
/ drug therapy
Pregnancy
Pregnancy Complications
/ drug therapy
Pregnancy Outcome
Retrospective Studies
Treatment Outcome
Journal
Journal of addiction medicine
ISSN: 1935-3227
Titre abrégé: J Addict Med
Pays: Netherlands
ID NLM: 101306759
Informations de publication
Date de publication:
Historique:
pubmed:
1
10
2019
medline:
1
6
2021
entrez:
1
10
2019
Statut:
ppublish
Résumé
To compare maternal and fetal outcomes among dyads prescribed buprenorphine and naloxone or buprenorphine during pregnancy. Retrospective cohort study of patients with opioid use disorder obtaining care in a comprehensive, perinatal program. Patients utilized medication for opioid use disorder: a buprenorphine and naloxone combination product or buprenorphine monotherapy. The primary outcome was neonatal abstinence syndrome requiring treatment. Maternal secondary outcomes included: negative urine drug screen at delivery, obstetrical care attendance, primary cesarean delivery, and preterm delivery. Neonatal secondary outcomes included neonatal biometry, admission to neonatal intensive care, appropriate findings on cord toxicology, and length of stay. Univariate analyses included Chi square, Fisher exact, t-, or Mann-Whitney tests, as appropriate. Multivariate binary logistic regressions examined the association of type of buprenorphine product with diagnosis of neonatal abstinence syndrome requiring treatment and adjusted for variables significantly different in between-group comparisons and correlates of treatments and the primary outcome. The rate of neonatal abstinence syndrome was significantly higher (P = 0.007) among infants exposed in utero to buprenorphine versus buprenorphine and naloxone: 59/108 (54.6%) versus 30/85 (35.3%), respectively. The combined product, relative to the monoproduct, was associated with lower odds of neonatal abstinence syndrome: odds ratio (OR) = 0.453 (95% confidence interval [CI] 0.253-0.813; P = 0.008). Adjusting for dose of buprenorphine product at delivery, year of expected delivery, type of prescriber, diagnosis of hepatitis C, and preterm delivery negated these results: adjusted OR = 0.627 (95% CI 0.309-1.275). Secondary outcomes were similar. Compared with buprenorphine monotherapy, the combined buprenorphine and naloxone product was an acceptable alternative pharmacologic treatment for opioid use disorder during pregnancy.
Identifiants
pubmed: 31567599
doi: 10.1097/ADM.0000000000000562
pii: 01271255-202006000-00003
doi:
Substances chimiques
Analgesics, Opioid
0
Drug Combinations
0
Naloxone
36B82AMQ7N
Buprenorphine
40D3SCR4GZ
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
185-192Références
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