A new study reveals that consistent and moderate use of buprenorphine throughout pregnancy for women with opioid use disorder (OUD) is associated with better postpartum treatment adherence and fewer overdose incidents. The research, which analyzed data from the Pennsylvania Medicaid program, found no negative impact on neonatal health outcomes.
Higher doses and a longer duration of buprenorphine use throughout pregnancy for opioid use disorder (OUD) are associated with improved postpartum treatment retention and fewer overdose events, with no adverse neonatal outcomes.The retrospective study used data from the Pennsylvania Medicaid program to assess the effect of buprenorphine use on maternal and neonatal health outcomes in 2925 pregnant women with OUD (mean age, 29 years) who had a live birth from 2009 to 2019.
The included women received at least two buprenorphine prescriptions and did not use methadone during pregnancy and postpartum. They were followed from the start of pregnancy through 90 days after birth. Three trajectory groups were identified: Those who initiated buprenorphine before pregnancy and had consistent usage throughout pregnancy, those who initiated buprenorphine during pregnancy, and those who used buprenorphine before pregnancy but discontinued it during pregnancy; varying doses were noted within each trajectory group. Outcomes include buprenorphine continuation after birth, overdose, weeks at delivery date, low birthweight (birthweight ≤ 2500 g at delivery), and neonatal abstinence syndrome.Women who consistently used buprenorphine at moderate doses (mean daily dose, 14.76 mg) were 81% more likely to continue its use after 90 days of delivery than those who consistently used high doses (mean daily dose, 22.35 mg; adjusted odds ratio , 1.81; 95% CI, 1.09-2.98). Second-trimester buprenorphine initiation at moderate doses was associated with 44% lower odds of postpartum treatment continuation than consistent usage at high doses (aOR, 0.56; 95% CI, 0.43-0.73). The rates of buprenorphine overdose either during pregnancy or after giving birth were higher among women who discontinued its use during pregnancy (18.3 per 1000 pregnant patients) and those who initiated it during pregnancy (21.9 per 1000) than among those who started the medication before pregnancy and maintained use (
OPIOID USE DISORDER PREGNANCY BUPRENORPHINE POSTPARTUM CARE NEONATAL HEALTH
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