title: Neonatal outcomes and their relationship to maternal buprenorphine dose during pregnancy.
abstract: BACKGROUND
  Buprenorphine pharmacotherapy for opioid-dependent pregnant women is associated with maternal and neonatal outcomes superior to untreated opioid dependence. However, the literature is inconsistent regarding the possible existence of a dose-response relationship between maternal buprenorphine dose and neonatal clinical outcomes.
  
  
  METHODS
  The present secondary analysis study (1) examined the relationship between maternal buprenorphine dose at delivery and neonatal abstinence syndrome (NAS) peak score, estimated gestational age at delivery, Apgar scores at 1 and 5 min, neonatal head circumference, length, and weight at birth, amount of morphine needed to treat NAS, duration of NAS treatment, and duration of neonatal hospital stay and (2) compared neonates who required pharmacotherapy for NAS to neonates who did not require such pharmacotherapy on these same outcomes, in 58 opioid-dependent pregnant women receiving buprenorphine as participants in a randomized clinical trial.
  
  
  RESULTS
  (1) Analyses failed to provide evidence of a relationship between maternal buprenorphine dose at delivery and any of the 10 outcomes (all p-values>.48) and (2) significant mean differences between the untreated (n=31) and treated (n=27) for NAS groups were found for duration of neonatal hospital stay and NAS peak score (both p-values<.001).
  
  
  CONCLUSIONS
  (1) Findings failed to support the existence of a dose-response relationship between maternal buprenorphine dose at delivery and any of 10 neonatal clinical outcomes, including NAS severity and (2) that infants treated for NAS had a higher mean NAS peak score and, spent a longer time in the hospital than did the group not treated for NAS is unsurprising.
authors.affiliation: UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Carrboro, NC 27510, USA; Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD 21224, USA. Electronic address: hendree_jones@med.unc.edu.
authors.forename: Hendrée E
authors.initials: HE
authors.lastname: Jones
authors.affiliation: Department of Neuroscience, Washington and Lee University, Lexington, VA 24450, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Dengler
authors.affiliation: Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Garrison
authors.affiliation: Department of Psychology, University of Maryland, College Park, College Park, MD 20742, USA.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: O'Grady
authors.affiliation: Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Seashore
authors.affiliation: UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Carrboro, NC 27510, USA.
authors.forename: Evette
authors.initials: E
authors.lastname: Horton
authors.affiliation: UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Carrboro, NC 27510, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: Andringa
authors.affiliation: Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD 21224, USA.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Jansson
authors.affiliation: UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Carrboro, NC 27510, USA.
authors.forename: John
authors.initials: J
authors.lastname: Thorp
mesh_terms: D002047:Buprenorphine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy* / Q000453:epidemiology; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000453:epidemiology; D011256:Pregnancy Outcome / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D002047:Buprenorphine
keywords: Buprenorphine; Neonatal abstinence syndrome; Neonate; Opioid use disorder; Pregnancy