title: Infections and obstetric outcomes in opioid-dependent pregnant women maintained on methadone or buprenorphine.
abstract: OBJECTIVE
  To characterize infections and compare obstetric outcomes in opioid-dependent pregnant women who participated in a randomized clinical trial comparing agonist medications, methadone and buprenorphine.
  
  
  METHODS
  Incidence of infections was identified as part of the screening medical assessment. As part of a planned secondary analysis, analysis of variance and polytomous logistic regressions were conducted on obstetric outcome variables using treatment randomization condition (maternal maintenance with either methadone or buprenorphine) as the predictor variable, controlling for differences between study sites.
  
  
  METHODS
  Six United States sites and one European site that provided comprehensive treatment to opioid-dependent pregnant women.
  
  
  METHODS
  Pregnant opioid-dependent women (n = 131) who delivered while participating in the Maternal Opioid Treatment: Human Experimental Research (MOTHER) study.
  
  
  METHODS
  Obstetric, infectious and other maternal medical complications captured by medical records, physical examination, blood tests and self-report. Neonatal medical complications captured by medical records.
  
  
  RESULTS
  Hepatitis C was the most common infection (32.3%), followed by hepatitis B (7.6%) and chlamydia (6.1%) among participants at study enrollment. Maternal methadone versus buprenorphine maintenance was associated with a higher incidence of preterm labor (P = 0.04) and a significantly higher percentage of signs of respiratory distress in neonates at delivery (P = 0.05). Other medical and obstetric complications were infrequent in the total sample, as well as in both methadone and buprenorphine conditions.
  
  
  CONCLUSIONS
  Buprenorphine appears to have an acceptable safety profile for use during pregnancy.
authors.affiliation: Department of Pediatrics, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Amber M
authors.initials: AM
authors.lastname: Holbrook
authors.forename: Jason K
authors.initials: JK
authors.lastname: Baxter
authors.forename: Hendrée E
authors.initials: HE
authors.lastname: Jones
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Heil
authors.forename: Mara G
authors.initials: MG
authors.lastname: Coyle
authors.forename: Peter R
authors.initials: PR
authors.lastname: Martin
authors.forename: Susan M
authors.initials: SM
authors.lastname: Stine
authors.forename: Karol
authors.initials: K
authors.lastname: Kaltenbach
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000704:Analysis of Variance; D002047:Buprenorphine / Q000627:therapeutic use*; D003141:Communicable Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D016015:Logistic Models; D008691:Methadone / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D008691:Methadone