ADVERTISEMENT
Buprenorphine During Pregnancy Associated With Less Neonatal Risk Than Methadone
Pregnant women with opioid use disorder may have more favorable neonatal health outcomes with buprenorphine compared with methadone treatment, according to a study in the New England Journal of Medicine.
“Our results may encourage increasing access to buprenorphine treatment specifically among pregnant people,” said study lead author Elizabeth Suarez, PhD, a pharmacoepidemiologist on faculty at the Center for Pharmacoepidemiology and Treatment Science at the Rutgers Institute for Health, Health Care Policy, and Aging Research, New Brunswick, New Jersey.
Researchers investigated maternal and infant outcomes in pregnant women with opioid use disorder who were insured by Medicaid and treated with buprenorphine and methadone. Exposure to buprenorphine was assessed in 10,704 women in early pregnancy (through gestational week 19), 11,272 women in late pregnancy (gestational week 20 through the day before delivery), and 9976 women in the 30 days before delivery. Methadone exposure was assessed in 4387 women in early pregnancy, 5056 women in late pregnancy, and 4597 women in the month before delivery.
Buprenorphine use was associated with lower risk of preterm birth, small size for gestational age, low birth weight, and neonatal abstinence syndrome compared with methadone use, researchers reported.
Specifically, neonatal abstinence syndrome occurred in 52.0% of infants exposed to buprenorphine and in 69.2% exposed to methadone in the month before delivery, according to the study. Preterm birth occurred in 14.4% exposed to buprenorphine and in 24.9% exposed to methadone in early pregnancy; small size for gestational age in 12.1% exposed to buprenorphine and 15.3% exposed to methadone; and low birth weight in 8.3% exposed to buprenorphine and 14.9% exposed to methadone.
Results for exposure in late pregnancy were consistent with early exposure, researchers added.
Meanwhile, the risk of adverse maternal outcomes was similar between the 2 treatments: Rates of Cesarean section delivery were 33.6% with buprenorphine and 33.1% with methadone in early pregnancy, and rates of severe maternal complications were 3.3% with buprenorphine and 3.5% with methadone, the study found.
“These results may guide clinical recommendations for people with opioid use disorder who are pregnant or are hoping to be pregnant,” said Dr Suarez.
References
