Maternal buprenorphine treatment and infant outcome

Lauren M. Jansson, Martha L. Velez, Krystle McConnell, Nancy Spencer, Michelle Tuten, Hendree Jones, Rebeca Rios, Van L. King, Neeraj Gandotra, Lorraine Millio, Janet A. DiPietro

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Background and objectives Maternal buprenorphine maintenance predisposes the infant to exhibit neonatal abstinence syndrome (NAS), but there is insufficient published information regarding the nature of NAS and factors that contribute to its severity in buprenorphine-exposed infants. Methods The present study evaluated forty-one infants of buprenorphine-maintained women in comprehensive substance use disorder treatment who participated in an open-label study examining the effects of maternal buprenorphine maintenance on infant outcomes. Modifiers of the infant outcomes, including maternal treatment and substance use disorder parameters, were also evaluated. Results Fifty-nine percent of offspring exhibited NAS that required pharmacologic management. Both maternal buprenorphine dose as well as prenatal polysubstance exposure to illicit substance use/licit substance misuse were independently associated with NAS expression. Polysubstance exposure was associated with more severe NAS expression after controlling for the effects of buprenorphine dose. Other exposures, including cigarette smoking and SRI use, were not related to outcomes. Maternal buprenorphine dose was positively associated with lower birth weight and length. Conclusions Polysubstance exposure was the most potent predictor of NAS severity in this sample of buprenorphine-exposed neonates. This finding suggests the need for interventions that reduce maternal polysubstance use during medication assisted treatment for opioid use disorder, and highlights the necessity of a comprehensive approach, beyond buprenorphine treatment alone, for the optimal care for pregnant women with opioid use disorders.

Original languageEnglish (US)
Pages (from-to)56-61
Number of pages6
JournalDrug and Alcohol Dependence
Volume180
DOIs
StatePublished - Nov 1 2017
Externally publishedYes

Keywords

  • Buprenorphine
  • Maternal opioid use disorder
  • Medication assisted treatment during pregnancy
  • Neonatal abstinence syndrome
  • Opioid exposed neonate
  • Perinatal substance use disorder treatment
  • Substance exposed neonate

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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  • Cite this

    Jansson, L. M., Velez, M. L., McConnell, K., Spencer, N., Tuten, M., Jones, H., Rios, R., King, V. L., Gandotra, N., Millio, L., & DiPietro, J. A. (2017). Maternal buprenorphine treatment and infant outcome. Drug and Alcohol Dependence, 180, 56-61. https://doi.org/10.1016/j.drugalcdep.2017.08.001