Comparison of buprenorphine and methadone in the management of maternal opioid use disorder in full term pregnancies
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Cara L. Staszewski
Abstract
Objectives
To compare pregnancy outcomes with medication assisted treatment using. methadone or buprenorphine in term mothers with opioid use disorder.
Methods
A cohort of women receiving medication assisted treatment with either methadone or buprenorphine were identified from delivery records over a 10‐year period. Women were excluded with delivery <37 weeks, multiple gestations, or a known anomalous fetus. Maternal demographics, medications, mode of delivery, birthweight, newborn length of stay, and neonatal abstinence syndrome were extracted. The study was IRB approved and a p-value of <0.05 was significant.
Results
There were 260 women, 140 (53.8%) with methadone use and 120 (46.2%) with buprenorphine use. Groups were similar for maternal age, race, parity, homeless rate, tobacco use, mode of delivery and incidence of neonatal abstinence syndrome. The methadone group had a lower mean newborn birthweight (2874±459 g) and a greater incidence of low birth weight (11.4%) than the buprenorphine group (3282±452 g; p<0.001 and 2.5%; p=0.006). The incidence of neonatal abstinence syndrome was similar between groups (97% methadone vs. 92.5% buprenorphine; p=0.08). The methadone group had a longer newborn length of stay (11.4+7.4 days) and more newborn treatment with morphine (44.6%) than the buprenorphine group (8.2+4.4 days; p<0.001 and 24.2%; p<0.001). Maternal methadone use was an independent predictor for a newborn length of hospital stay >7 days (OR 3.61; 95% confidence interval 1.32–9.86; p=0.01).
Conclusions
Medication assisted treatment favors buprenorphine use when compared to. methadone with an increased birthweight, reduced need for newborn treatment, and a shorter newborn length of stay in term infants.
Research funding: None declared.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The study was IRB approved (CORHIS # 2017-4117-R1).
References
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© 2020 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Review
- Perinatal outcomes in vanishing twin pregnancies following assisted reproductive technology (ART) – a systematic review and meta-analysis
- Mini Review
- Cervical insufficiency: a noteworthy disease with controversies
- Original Articles – Obstetrics
- Individualized birth length and head circumference percentile charts based on maternal body weight and height
- Cellular immune responses in amniotic fluid of women with a sonographic short cervix
- Comparison of buprenorphine and methadone in the management of maternal opioid use disorder in full term pregnancies
- Influence of newborn head circumference and birth weight on the delivery mode of primipara: what is more important?
- Estimated fetal weight and severe neonatal outcomes in preterm prelabor rupture of membranes
- Which technique is better to place a manoeuvrable vacuum extractor cup on the flexion point? Vacca vs. Bird technique
- Pregnancy-specific transcriptional changes upon endotoxin exposure in mice
- Effects of nifedipine on fetal cardiac function in preterm labor
- Violence against trainees: urgent ethical challenges for medical educators and academic leaders in perinatal medicine
- Original Articles – Newborns
- Comparison of image quality in brain MRI with and without MR compatible incubator and predictive value of brain MRI at expected delivery date in preterm babies
- Survey on clinical use and non-use of recombinant human erythropoietin in European neonatal units
- An alternative approach to developing guidelines for the management of an anticipated extremely preterm infant
Artikel in diesem Heft
- Frontmatter
- Review
- Perinatal outcomes in vanishing twin pregnancies following assisted reproductive technology (ART) – a systematic review and meta-analysis
- Mini Review
- Cervical insufficiency: a noteworthy disease with controversies
- Original Articles – Obstetrics
- Individualized birth length and head circumference percentile charts based on maternal body weight and height
- Cellular immune responses in amniotic fluid of women with a sonographic short cervix
- Comparison of buprenorphine and methadone in the management of maternal opioid use disorder in full term pregnancies
- Influence of newborn head circumference and birth weight on the delivery mode of primipara: what is more important?
- Estimated fetal weight and severe neonatal outcomes in preterm prelabor rupture of membranes
- Which technique is better to place a manoeuvrable vacuum extractor cup on the flexion point? Vacca vs. Bird technique
- Pregnancy-specific transcriptional changes upon endotoxin exposure in mice
- Effects of nifedipine on fetal cardiac function in preterm labor
- Violence against trainees: urgent ethical challenges for medical educators and academic leaders in perinatal medicine
- Original Articles – Newborns
- Comparison of image quality in brain MRI with and without MR compatible incubator and predictive value of brain MRI at expected delivery date in preterm babies
- Survey on clinical use and non-use of recombinant human erythropoietin in European neonatal units
- An alternative approach to developing guidelines for the management of an anticipated extremely preterm infant
