title: Neonatal neurobehavior effects following buprenorphine versus methadone exposure.
abstract: OBJECTIVE
  To determine the effects of in utero exposure to methadone or buprenorphine on infant neurobehavior.
  
  
  METHODS
  Three sites from the Maternal Opioid Treatment: Human Experimental Research (MOTHER) study, a double-blind, double-dummy, randomized clinical trial participated in this substudy.
  
  
  METHODS
  Medical Centers that provided comprehensive maternal care to opioid-dependent pregnant women in Baltimore, MD, Providence, RI and Vienna, Austria.
  
  
  METHODS
  Thirty-nine full-term infants.
  
  
  METHODS
  The Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale (NNNS) was administered to a subgroup of infants on postpartum days 3, 5, 7, 10, 14-15 and 28-30.
  
  
  RESULTS
  While neurobehavior improved for both medication conditions over time, infants exposed in utero to buprenorphine exhibited fewer stress-abstinence signs (P < 0.001), were less excitable (P < 0.001) and less over-aroused (P < 0.01), exhibited less hypertonia (P < 0.007), had better self-regulation (P < 0.04) and required less handling (P < 0.001) to maintain a quiet alert state relative to in utero methadone-exposed infants. Infants who were older when they began morphine treatment for withdrawal had higher self-regulation scores (P < 0.01), and demonstrated the least amount of excitability (P < 0.02) and hypertonia (P < 0.02) on average. Quality of movement was correlated negatively with peak NAS score (P < 0.01), number of days treated with morphine for NAS (P < 0.01) and total amount of morphine received (P < 0.03). Excitability scores were related positively to total morphine dose (P < 0.03).
  
  
  CONCLUSIONS
  While neurobehavior improves during the first month of postnatal life for in utero agonist medication-exposed neonates, buprenorphine exposure results in superior neurobehavioral scores and less severe withdrawal than does methadone exposure.
authors.affiliation: Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, RI, USA. coylem@southcoast.org
authors.forename: Mara G
authors.initials: MG
authors.lastname: Coyle
authors.forename: Amy L
authors.initials: AL
authors.lastname: Salisbury
authors.forename: Barry M
authors.initials: BM
authors.lastname: Lester
authors.forename: Hendrée E
authors.initials: HE
authors.lastname: Jones
authors.forename: Hai
authors.initials: H
authors.lastname: Lin
authors.forename: Klaudia
authors.initials: K
authors.lastname: Graf-Rohrmeister
authors.forename: Gabriele
authors.initials: G
authors.lastname: Fischer
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects*; D002047:Buprenorphine / Q000009:adverse effects*; D005260:Female; D006801:Humans; D018730:Infant Behavior / Q000187:drug effects*; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D008691:Methadone / Q000009:adverse effects*; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy / Q000503:physiopathology*; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011297:Prenatal Exposure Delayed Effects; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D009020:Morphine; D008691:Methadone