Impact of Maternal Buprenorphine Dose on Severity or Incidence of Neonatal Abstinence Syndrome.


eMediNexus    23 June 2018

The purpose of a new study, published in the Journal of Addiction Medicine, was to measure the incidence, onset, duration, and severity of neonatal abstinence syndrome (NAS) in infants born to mothers receiving buprenorphine and to assess the association between buprenorphine dose and NAS outcomes. Charts of all mother-infant pairs, maintained on buprenorphine, who delivered in a hospital from January 1, 2000 to April 1, 2016 were reviewed. The results revealed that in 89 infants, NAS incidence requiring morphine was 43.8%. Means for morphine-treated infants included: 55.2 hours to morphine start, 15.9 days on morphine, and 20 days hospital stay. NAS requiring morphine treatment occurred in 48.5% and 41.4% of infants of mothers receiving ≤8 mg/d buprenorphine versus >8 mg/d, respectively. Whereas, significant associations of maternal buprenorphine dose with peak NAS score, NAS severity requiring morphine, time to morphine start, peak morphine dose, or days on morphine could not be established. Meanwhile, only exclusive breastfeeding was significantly associated with neonatal outcomes, in particular, lower odds of morphine treatment. The findings indicated that higher buprenorphine doses can be prescribed to pregnant women receiving medication therapy for addiction without increasing NAS severity. From the results, it was inferred that breastfeeding is both safe and beneficial for these infants and should be encouraged.

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