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Licensed Unlicensed Requires Authentication Published by De Gruyter July 20, 2020

Comparison of buprenorphine and methadone in the management of maternal opioid use disorder in full term pregnancies

Cara L. Staszewski, Diana Garretto, Evan T. Garry, Victoria Ly, Jay A. Davis and Kimberly M. Herrera

Abstract

Objectives

To compare pregnancy outcomes with medication assisted treatment using. methadone or buprenorphine in term mothers with opioid use disorder.

Methods

A cohort of women receiving medication assisted treatment with either methadone or buprenorphine were identified from delivery records over a 10‐year period. Women were excluded with delivery <37 weeks, multiple gestations, or a known anomalous fetus. Maternal demographics, medications, mode of delivery, birthweight, newborn length of stay, and neonatal abstinence syndrome were extracted. The study was IRB approved and a p-value of <0.05 was significant.

Results

There were 260 women, 140 (53.8%) with methadone use and 120 (46.2%) with buprenorphine use. Groups were similar for maternal age, race, parity, homeless rate, tobacco use, mode of delivery and incidence of neonatal abstinence syndrome. The methadone group had a lower mean newborn birthweight (2874±459 g) and a greater incidence of low birth weight (11.4%) than the buprenorphine group (3282±452 g; p<0.001 and 2.5%; p=0.006). The incidence of neonatal abstinence syndrome was similar between groups (97% methadone vs. 92.5% buprenorphine; p=0.08). The methadone group had a longer newborn length of stay (11.4+7.4 days) and more newborn treatment with morphine (44.6%) than the buprenorphine group (8.2+4.4 days; p<0.001 and 24.2%; p<0.001). Maternal methadone use was an independent predictor for a newborn length of hospital stay >7 days (OR 3.61; 95% confidence interval 1.32–9.86; p=0.01).

Conclusions

Medication assisted treatment favors buprenorphine use when compared to. methadone with an increased birthweight, reduced need for newborn treatment, and a shorter newborn length of stay in term infants.


Corresponding author: Kimberly M. Herrera, MD, Department of Obstetrics & Gynecology and Reproductive Medicine, Renaissance School of Medicine at Stony Brook University, HSC T-9 Room 030 101 Nicolls Road, Stony Brook, NY11794, USA, Phone: 641-444-7650, Fax: 631-444-3944, E-mail:

  1. Research funding: None declared.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The study was IRB approved (CORHIS # 2017-4117-R1).

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Received: 2020-03-11
Accepted: 2020-06-20
Published Online: 2020-07-20
Published in Print: 2020-09-25

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