Buprenorphine Reduces Risk of Adverse Neonatal Outcomes - MD Magazine

Pregnant individuals with opioid usage disorder (OUD) treated with buprenorphine person much favorable outcomes than those treated with methadone.

A team, led by Elizabeth A. Suarez, PhD, compared the 2 treatments successful a ample cohort of large individuals.

Standard attraction regimens for large individuals with opioid usage upset includes opioid agonist therapy, including buprenorphine, which whitethorn beryllium associated with much favorable neonatal and maternal outcomes compared to methadone.

However, the information comparing the 2 treatments is constricted successful this diligent population.

In the cohort study, the investigators examined information connected large individuals enrolled successful nationalist security programs successful the US betwixt 2000-2018. The squad looked astatine outcomes among patients treated with buprenorphine compared to those who were treated with methadone.

The investigators assessed vulnerability to the 2 medications successful aboriginal pregnancy, defined arsenic done gestational week 19, aboriginal pregnancy, defined arsenic gestational week 20 done the time earlier delivery, and the 30 days anterior to delivery.

They besides adjusted hazard ratios for neonatal and maternal outcomes for confounders with the usage of propensity-score overlap weights.

Overall, the squad analyzed information from 2.5 cardinal pregnancies that ended successful unrecorded births. A full of 10,704 of large participants were exposed to buprenorphine successful aboriginal pregnancy, compared to 4387 individuals exposed to methadone.

In precocious pregnancy, 11,272 individuals were exposed to buprenorphine, compared to 5056 individuals exposed to methadone (9976 and 4597, respectively, successful the 30 days earlier delivery).

In addition, 52% of infants exposed to buprenorphine successful the 30 days anterior to transportation had neonatal abstinence syndrome, compared to 69.2% of those exposed to methadone (aRR, 0.73; 95% CI, 0.71-0.75).

The investigators besides recorded information connected preterm births.

Here, they recovered 14.4% of infants exposed to buprenorphine successful aboriginal gestation and 24.9% of infants exposed to methadone (aRR, 0.58; 95%, 0.53-0.62) were preterm births.

For tiny size for gestational age, 12.1% of the buprenorphine radical and 15.3% of the methadone radical were successful this class (aRR, 0.72; 95% CI, 0.66-0.80).

Low commencement value occurred successful 8.3% and 14.9% of the cohorts, respectively (aRR, 0.56; 95% CI, 0.50-0.63).

Delivery by cesarean conception occurred successful 33.6% of the buprenorphine radical successful aboriginal pregnancy, compared to 33.1% of the methadone radical (aRR, 1.02; 95% CI, 0.74-1.13).

The results of vulnerability successful precocious gestation were accordant with results of vulnerability successful aboriginal pregnancy.

“The usage of buprenorphine successful gestation was associated with a little hazard of adverse neonatal outcomes than methadone use; however, the hazard of adverse maternal outcomes was akin among persons who received buprenorphine and those who received methadone,” the authors wrote.

The study, “Buprenorphine versus Methadone for Opioid Use Disorder successful Pregnancy,” was published online successful the New England Journal of Medicine.