Fetal assessment before and after dosing with buprenorphine or methadone (original) (raw)
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Fetal neurobehavioral effects of exposure to methadone or buprenorphine
Neurotoxicology and Teratology, 2011
As part of a double-blind study of medication treatment for opioid dependence during pregnancy, 17 opioid-dependent pregnant women maintained on either buprenorphine or methadone underwent fetal monitoring at 24, 28, 32, and 36 weeks gestation. Maternal demographic information and infant outcomes did not significantly differ by medication group. Earlier in gestation (24 and 28 weeks), buprenorphine-exposed fetuses had higher levels of fetal heart rate variability, more accelerations in fetal heart rate and greater coupling between fetal heart rate and fetal movement than the methadone-exposed group (all p's <.05). Later in gestation (32 and 36 weeks), buprenorphine-exposed fetuses displayed less suppression of motor activity and longer duration of movements than the methadone-exposed group (all p's <.05). These results may have implications for the optimal treatment of the opioid-dependent pregnant woman.
Substance Abuse: Research and Treatment, 2013
Given that buprenorphine + naloxone is prescribed for opioid-dependent pregnant women, it is important to examine the extent to which it differs from buprenorphine alone, methadone, or methadone-assisted withdrawal on neonatal and maternal outcomes. Summary statistics on maternal and neonatal outcomes were collected from 7 previously published studies examining treatment for opioid-dependent pregnant women that represented a range of research methodologies. Outcomes from these studies were compared to the same outcomes for 10 women treated with the combined buprenorphine + naloxone product. There were no significant differences in maternal outcomes for buprenorphine + naloxone compared to buprenorphine, methadone, or methadone-assisted withdrawal. Preliminary findings suggest no significant adverse maternal or neonatal outcomes related to the use of buprenorphine + naloxone for the treatment of opioid dependence during pregnancy. However, further research should examine possible differences between buprenorphine + naloxone and buprenorphine alone or methadone in fetal physical development.
Drug and Alcohol Dependence, 2005
This study was designed to compare the neonatal abstinence syndrome (NAS) in neonates of methadone and buprenorphine maintained pregnant opioid-dependent women and to provide preliminary safety and efficacy data for a larger multi-center trial. This randomized, double-blind, double-dummy, flexible dosing, parallel-group controlled trial was conducted in a comprehensive drug-treatment facility that included residential and ambulatory care. Participants were opioid-dependent pregnant women and their neonates. Treatment involved daily administration of either sublingual buprenorphine or oral methadone using flexible dosing of 4-24 mg or 20-100 mg, respectively. Primary a priori outcome measures were: (1) number of neonates treated for NAS; (2) amount of opioid agonist medication used to treat NAS;
Methadone versus buprenorphine in pregnant addicts: a double-blind, double-dummy comparison study
Addiction, 2006
Aims To evaluate the efficacy and safety of methadone versus buprenorphine treatment in pregnant opioiddependent women. Design Randomized, double-dummy, double-blind, flexible-dosing comparison study. Setting Addiction Clinic at the Medical University of Vienna, Austria. Participants Eighteen women were assigned randomly to receive either methadone ( n = 9) or buprenorphine ( n = 9) during weeks 24-29 of pregnancy. After dropouts, data were available from 14 cases (six in the methadone and eight in the buprenorphine group). Intervention Sublingual buprenorphine tablets (8-24 mg/day) or oral methadone solution (40-100 mg/day), with matched placebos. Measurements Mothers: retention in treatment, urine toxicology and nicotine use. Neonates: Routine birth data, neonatal abstinence syndrome (NAS) in severity and duration. Findings There was somewhat greater retention in the buprenorphine group but significantly lowered use of additional opioids in the methadone group ( P = 0.047). Neonates: There was earlier onset of NAS in neonates born to the methadone (mean 60 hours) than to the buprenorphine groups (mean 72 hours after last medication); 43% did not require NAS-treatment with short treatment duration in both groups (mean 5 days). Conclusion This preliminary study had limited power to detect differences but the trends observed suggest this kind of research is practicable and that further studies are warranted.
Maternal buprenorphine treatment and fetal neurobehavioral development
American journal of obstetrics and gynecology, 2017
Gestational opioid use/misuse is escalating in the United States, however, little is understood about the fetal effects of medications used to treat maternal opioid use disorders. The purpose of this study was to determine the effect of maternal buprenorphine administration on longitudinal fetal neurobehavioral development. Forty-nine buprenorphine-maintained women attending a substance use disorder treatment facility with generally uncomplicated pregnancies underwent fetal monitoring for 60 minutes at times of trough and peak maternal buprenorphine levels. Data were collected at 24, 28, 32, and 36 weeks gestation. Fetal neurobehavioral indicators (i.e., heart rate, motor activity and their integration (fetal movement-fetal heart rate coupling)) were collected via an actocardiograph, digitized and quantified. Longitudinal data analysis relied on hierarchical linear modeling. Fetal heart rate, heart rate variability and heart rate accelerations were significantly reduced at peak vers...