Perinatal outcomes of Australian buprenorphine-exposed mothers and their newborn infants

J Paediatr Child Health. 2013 Sep;49(9):746-53. doi: 10.1111/jpc.12264. Epub 2013 Jun 9.

Abstract

Aim: To determine the short-term outcomes of Australian buprenorphine-exposed mother/infant dyads.

Methods: Retrospective record review of drug-exposed mothers and infants in Australia. Groups were based on drug exposure: buprenorphine (55, 3.8%), non-buprenorphine opiates (O, 686, 48.6%) and non-opiates (NO, 671, 47.5%).

Results: More than 30% of buprenorphine mothers continued to use heroin (21, 38%) and benzodiazepines (16, 29%). They were more likely to have child at risk concerns (29, 52.7%, P = 0.019) and have previous children placed in out-of-home care (9, 16.3%, P = 049). Buprenorphine babies were less likely to be preterm (16% vs. 25% (O), P = 0.001 and 23% (NO), P = 0.004) and had higher birthweights (median: 3165 g vs. 2842.5 g (O), P < 0.001 and 2900 g (NO), P = 0.004). Buprenorphine and non-buprenorphine opioid babies had similar maximum Finnegan scores (median 10 vs. 11(O), P = 0.144). The number of babies needing abstinence treatment (45% vs. 51% (O), P = 0.411) and length of hospital stay (median days 9 vs. 11(O), P = 0.067) were similar, but buprenorphine infants required lower maximum morphine doses (mg/kg/day) (median 0.4 mg vs. 0.5 mg (O), P = 0.009).

Conclusions: Short-term medical outcomes of infants of buprenorphine-using mothers are similar to those of non-buprenorphine opiate-using mothers, but interpretation of these results is confounded by the high rates of polydrug exposure in the buprenorphine group. This and other social concerns noted in buprenorphine mothers and infants warrant further study.

Keywords: buprenorphine; neonatal abstinence syndrome; pregnancy.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Australian Capital Territory
  • Buprenorphine / adverse effects
  • Buprenorphine / therapeutic use*
  • Female
  • Humans
  • Infant, Newborn
  • Medical Audit
  • Morphine / therapeutic use
  • Neonatal Abstinence Syndrome / drug therapy
  • Neonatal Abstinence Syndrome / etiology*
  • New South Wales
  • Opiate Substitution Treatment / adverse effects*
  • Opioid-Related Disorders / drug therapy*
  • Pregnancy
  • Pregnancy Complications / drug therapy*
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Analgesics, Opioid
  • Buprenorphine
  • Morphine