title: Buprenorphine Versus Methadone for Opioid Dependence in Pregnancy.
abstract: To evaluate maternal and neonatal safety outcomes for methadone and buprenorphine in the obstetric population.
  
  
  
  A literature search of PubMed (1966 to March 2016) and EMBASE (1973 to March 2016) was completed using the search terms buprenorphine, methadone, pregnancy, opioid, and neonatal abstinence syndrome Priority was given to randomized controlled trials and trials directly comparing buprenorphine and methadone during pregnancy. The bibliographies were reviewed for other relevant articles.
  
  
  
  All human studies published in English, that compared methadone and buprenorphine use in pregnancy were evaluated. Because of the limited number of obstetric studies, only 5 critical studies were found.
  
  
  
  Buprenorphine significantly improved or had similar outcomes to methadone for development of neonatal abstinence syndrome (NAS), percentage of infants requiring treatment for NAS (20%-47% vs 45.5%-57%, respectively), total amount of morphine used to treat NAS (0.472-3.4 vs 1.862-10.4 mg, respectively), duration of NAS (4.1-5.6 vs 5.3-9.9 days, respectively), peak NAS (3.9-11 vs 4.9-12.8 score, respectively), infant hospital stay (6.8-10.6 vs 8.1-17.5 days, respectively), and gestational age at delivery (38.8-39.7 vs 37.9-38.8 weeks, respectively). No difference was found with other neonatal or maternal outcomes.
  
  
  
  Both methadone and buprenorphine are effective agents, with improved safety compared with continued nonmedical opioid use during pregnancy. There is evidence to suggest that buprenorphine should be considered as an equivalent option to methadone for use in pregnancy; however, larger studies are still needed to fully evaluate buprenorphine safety and advantages over methadone in the obstetric population.
authors.affiliation: VA Outpatient Clinic, Corpus Christi, TX, USA anoor08@yahoo.com.
authors.forename: Arezo
authors.initials: A
authors.lastname: Noormohammadi
authors.affiliation: St Louis College of Pharmacy, St Louis, MO, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Forinash
authors.affiliation: St Louis College of Pharmacy, St Louis, MO, USA.
authors.forename: Abigail
authors.initials: A
authors.lastname: Yancey
authors.affiliation: St Louis College of Pharmacy, St Louis, MO, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Crannage
authors.affiliation: Esse Health/Southside Family Practice, St Louis, MO, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Campbell
authors.affiliation: Saint Louis University School of Medicine, St Louis, MO, USA.
authors.forename: Jaye
authors.initials: J
authors.lastname: Shyken
mesh_terms: D002047:Buprenorphine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008691:Methadone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009357:Neonatal Abstinence Syndrome / Q000517:prevention & control*; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
chemical_list: D002047:Buprenorphine; D008691:Methadone
keywords: alcohol; and substance abuse; drug; obstetrics/gynecology; pregnancy/drug effects; substance abuse; women’s health