Treatment of opioid-dependent pregnant women with buprenorphine.
OBJECTIVE
To assess the maternal and fetal acceptability of buprenorphine and neonatal abstinence syndrome (NAS) in children born to buprenorphine-maintained mothers.


METHODS
Open-label, flexible dosing, inpatient induction with outpatient maintenance, conducted at the University of Vienna within the existing pregnancy and drug addiction program.


METHODS
Fifteen opioid-dependent pregnant women.


METHODS
Sublingual buprenorphine tablets (1-10 mg/day).


METHODS
Mothers: withdrawal symptoms (Wang Scale), nicotine dependence (Fagerström Scale: FTQ) and urinalysis. Neonates: birth outcome and NAS (Finnegan Scale).


RESULTS
All subjects were opioid-, nicotine- and cannabis-dependent. Buprenorphine was well tolerated during induction (Wang Score < or = 4) and illicit opioid use was negligible (91% opioid-negative). All maternal, fetal and neonatal safety laboratory measures were within normal limits or not of clinical significance. Mean birth outcome measures including gestational age at delivery (39.6 +/- 1.5 weeks), Apgar scores (1 min = 8.9; 5 min = 9.9; and 10 min = 10), birth weight (3049 +/- 346 g), length (49.8 +/- 1.9 cm) and head circumference (34.1 +/- 1.8 cm) were within normal limits. The NAS was absent, mild (without treatment) and moderate (with treatment) in eight, four and three neonates, respectively. The mean duration of NAS was 1.1 days.


CONCLUSIONS
Buprenorphine appears to be well accepted by mother and fetus, and associated with a low incidence of NAS. Further investigation of buprenorphine as a maintenance agent for opioid-dependent pregnant women is needed.
Fischer
G
G
Department of General Psychiatry, University Hospital of Vienna, Austria. gabriele.fischer@akh-wien.ac.at
Johnson
R E
RE
Eder
H
H
Jagsch
R
R
Peternell
A
A
Weninger
M
M
Langer
M
M
Aschauer
H N
HN
D002047:Buprenorphine / Q000627:therapeutic use*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000534:rehabilitation*; D016896:Treatment Outcome
D009294:Narcotics; D002047:Buprenorphine