Care-by-parent model as a tool for reduction of neonatal opioid withdrawal syndrome in neonates exposed to buprenorphine maintenance therapy in-utero

J Matern Fetal Neonatal Med. 2020 Aug;33(16):2718-2722. doi: 10.1080/14767058.2018.1558201. Epub 2019 Jan 4.

Abstract

Objective: To determine if a structured care-by-parent (CBP) protocol is associated with a reduction in diagnosis of treatment-requiring Neonatal Opioid Withdrawal Syndrome (NOWS).Study design: We performed a pilot retrospective, case control study of pregnant women enrolled in a comprehensive prenatal care program for opioid-dependent patients during which they received buprenorphine for Medication Assisted Treatment (MAT) for Opioid Use Disorder (OUD). Patients who participated in the CBP program actively roomed-in with their infants even after maternal hospital discharge while infants continued to be monitored for development of treatment-requiring NOWS. The primary outcome was the rate of treatment-requiring NOWS in the CBP grouping.Results: Thirty-two (32) cases that were enrolled in the CBP model were compared with 32 matched controls that were not enrolled in this model. There was a significant reduction in the rate of treatment-requiring NOWS among cases compared to the controls (OR = 0.10; p = .001). Neonates undergoing CBP had a decreased length of stay and lower Finnegan scores compared to those who did not undergo CBPConclusion: Among infants born to mothers with OUD in pregnancy, CBP significantly reduces the rate of treatment-requiring NOWS.

Keywords: Buprenorphine; care by parent; medication assisted treatment; neonatal opioid withdrawal syndrome; opioid use disorder.

MeSH terms

  • Adult
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects*
  • Buprenorphine / administration & dosage
  • Buprenorphine / adverse effects*
  • Case-Control Studies
  • Female
  • Humans
  • Infant, Newborn
  • Mothers
  • Neonatal Abstinence Syndrome / diagnosis
  • Neonatal Abstinence Syndrome / prevention & control*
  • Opiate Substitution Treatment / methods*
  • Opioid-Related Disorders / drug therapy
  • Pilot Projects
  • Postnatal Care / methods
  • Pregnancy
  • Pregnancy Complications / drug therapy
  • Prenatal Care / methods
  • Retrospective Studies
  • Rooming-in Care

Substances

  • Analgesics, Opioid
  • Buprenorphine