Buprenorphine Use in Pregnancy May Reduce Risk for Adverse Neonatal Outcomes

Risk for preterm birth, small size for gestational age, low birth weight lower for those receiving buprenorphine versus methadone
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THURSDAY, Dec. 1, 2022 (HealthDay News) -- The risk for adverse neonatal outcomes is lower with use of buprenorphine versus methadone in pregnancy, according to a study published in the Dec. 1 issue of the New England Journal of Medicine.

Elizabeth A. Suarez, Ph.D., from Brigham and Women's Hospital in Boston, and colleagues conducted a cohort study involving pregnant persons enrolled in public insurance programs in the United States during 2000 to 2018. Exposure to buprenorphine and methadone was assessed in early pregnancy (through gestational week 19), late pregnancy (gestational week 20 through the day before delivery), and the 30 days before delivery; outcomes were compared between the groups. Data were included for 2,548,372 pregnancies that ended in live births.

The researchers found that neonatal abstinence syndrome occurred in 52.0 and 69.2 percent of infants who were exposed to buprenorphine and methadone, respectively, in the 30 days before delivery (adjusted relative risk, 0.73). Among infants exposed to buprenorphine and methadone, respectively, in early pregnancy, preterm birth occurred in 14.4 and 24.9 percent (adjusted relative risk, 0.58); small size for gestational age occurred in 12.1 and 15.3 percent (adjusted relative risk, 0.72); and low birth weight occurred in 8.3 and 14.9 percent (adjusted relative risk, 0.56). The risks for cesarean section and severe maternal complications did not differ significantly between the groups.

"Our results may encourage increasing access to buprenorphine treatment specifically among pregnant people," Suarez said in a statement. "It's essential for the general public to understand the importance of opioid use disorder treatment during pregnancy to avoid harms associated with lack of treatment."

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