Maternal Buprenorphine Dose at Delivery and Its Relationship to Neonatal Outcomes.
OBJECTIVE
To determine whether there is a dose-response relationship between maternal dose of buprenorphine at delivery and neonatal outcomes.


METHODS
This retrospective cohort study of 155 maternal-infant dyads exposed to buprenorphine during pregnancy examines the relationship between maternal dose of buprenorphine at delivery and gestational age, birthweight, method of delivery, Apgar scores at 1 and 5 min, duration of infant hospital stay, peak neonatal abstinence syndrome (NAS) score, duration of NAS and incidence of pharmacologic treatment of NAS.


RESULTS
Analyses failed to support any relationship between maternal dose of buprenorphine at delivery and any of the 9 clinical outcomes (all p values >0.093).


CONCLUSIONS
This study failed to provide any evidence to support limiting or reducing maternal dose of buprenorphine during pregnancy in order to reduce possible adverse outcomes to the infant. Findings suggest that healthcare providers can focus medication decisions on maternal opioid cravings to reduce the risk of relapse to illicit opioid use rather than out of concern for adverse infant outcomes.
Dartmouth Medical School, Maine Dartmouth Family Medicine Residency, Waterville, Maine, USA.
Alane B
AB
O'Connor
Liam
L
O'Brien
William A
WA
Alto
D000328:Adult; D001034:Apgar Score; D001724:Birth Weight / Q000187:drug effects; D002047:Buprenorphine / Q000008:administration & dosage* / Q000009:adverse effects*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D004305:Dose-Response Relationship, Drug; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data; D008281:Maine / Q000453:epidemiology; D008297:Male; D009292:Narcotic Antagonists / Q000009:adverse effects; D009357:Neonatal Abstinence Syndrome / Q000453:epidemiology*; D058850:Opiate Substitution Treatment / Q000009:adverse effects; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult
D009292:Narcotic Antagonists; D002047:Buprenorphine