Hendrée E Jones1, Erin Dengler2, Anna Garrison3, Kevin E O'Grady4, Carl Seashore5, Evette Horton6, Kim Andringa6, Lauren M Jansson7, John Thorp6. 1. UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Carrboro, NC 27510, USA; Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, School of Medicine, Johns Hopkins University, Baltimore, MD 21224, USA. Electronic address: hendree_jones@med.unc.edu. 2. Department of Neuroscience, Washington and Lee University, Lexington, VA 24450, USA. 3. Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA. 4. Department of Psychology, University of Maryland, College Park, College Park, MD 20742, USA. 5. Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA. 6. UNC Horizons and Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Carrboro, NC 27510, USA. 7. Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, MD 21224, USA.
Abstract
BACKGROUND:Buprenorphine pharmacotherapy for opioid-dependent pregnant women is associated with maternal and neonatal outcomes superior to untreated opioid dependence. However, the literature is inconsistent regarding the possible existence of a dose-response relationship between maternal buprenorphine dose and neonatal clinical outcomes. METHODS: The present secondary analysis study (1) examined the relationship between maternal buprenorphine dose at delivery and neonatal abstinence syndrome (NAS) peak score, estimated gestational age at delivery, Apgar scores at 1 and 5 min, neonatal head circumference, length, and weight at birth, amount of morphine needed to treat NAS, duration of NAS treatment, and duration of neonatal hospital stay and (2) compared neonates who required pharmacotherapy for NAS to neonates who did not require such pharmacotherapy on these same outcomes, in 58 opioid-dependent pregnant women receiving buprenorphine as participants in a randomized clinical trial. RESULTS: (1) Analyses failed to provide evidence of a relationship between maternal buprenorphine dose at delivery and any of the 10 outcomes (all p-values>.48) and (2) significant mean differences between the untreated (n=31) and treated (n=27) for NAS groups were found for duration of neonatal hospital stay and NAS peak score (both p-values<.001). CONCLUSIONS: (1) Findings failed to support the existence of a dose-response relationship between maternal buprenorphine dose at delivery and any of 10 neonatal clinical outcomes, including NAS severity and (2) that infants treated for NAS had a higher mean NAS peak score and, spent a longer time in the hospital than did the group not treated for NAS is unsurprising.
RCT Entities:
BACKGROUND:Buprenorphine pharmacotherapy for opioid-dependent pregnant women is associated with maternal and neonatal outcomes superior to untreated opioid dependence. However, the literature is inconsistent regarding the possible existence of a dose-response relationship between maternal buprenorphine dose and neonatal clinical outcomes. METHODS: The present secondary analysis study (1) examined the relationship between maternal buprenorphine dose at delivery and neonatal abstinence syndrome (NAS) peak score, estimated gestational age at delivery, Apgar scores at 1 and 5 min, neonatal head circumference, length, and weight at birth, amount of morphine needed to treat NAS, duration of NAS treatment, and duration of neonatal hospital stay and (2) compared neonates who required pharmacotherapy for NAS to neonates who did not require such pharmacotherapy on these same outcomes, in 58 opioid-dependent pregnant women receiving buprenorphine as participants in a randomized clinical trial. RESULTS: (1) Analyses failed to provide evidence of a relationship between maternal buprenorphine dose at delivery and any of the 10 outcomes (all p-values>.48) and (2) significant mean differences between the untreated (n=31) and treated (n=27) for NAS groups were found for duration of neonatal hospital stay and NAS peak score (both p-values<.001). CONCLUSIONS: (1) Findings failed to support the existence of a dose-response relationship between maternal buprenorphine dose at delivery and any of 10 neonatal clinical outcomes, including NAS severity and (2) that infants treated for NAS had a higher mean NAS peak score and, spent a longer time in the hospital than did the group not treated for NAS is unsurprising.
Authors: Stephen W Patrick; Robert E Schumacher; Brian D Benneyworth; Elizabeth E Krans; Jennifer M McAllister; Matthew M Davis Journal: JAMA Date: 2012-04-30 Impact factor: 56.272
Authors: Hendree E Jones; Rolley E Johnson; Donald R Jasinski; Kevin E O'Grady; Christian A Chisholm; Robin E Choo; Michael Crocetti; Robert Dudas; Cheryl Harrow; Marilyn A Huestis; Lauren M Jansson; Michael Lantz; Barry M Lester; Lorraine Milio Journal: Drug Alcohol Depend Date: 2005-07 Impact factor: 4.492
Authors: Hendrée E Jones; Sarah H Heil; Andjela Baewert; Amelia M Arria; Karol Kaltenbach; Peter R Martin; Mara G Coyle; Peter Selby; Susan M Stine; Gabriele Fischer Journal: Addiction Date: 2012-11 Impact factor: 6.526
Authors: Steve N Caritis; Jaime R Bastian; Hongfei Zhang; Hari Kalluri; Dennis English; Michael England; Stephanie Bobby; Raman Venkataramanan Journal: Am J Obstet Gynecol Date: 2017-06-29 Impact factor: 8.661
Authors: Irma Convertino; Alice Capogrosso Sansone; Alessandra Marino; Maria T Galiulo; Stefania Mantarro; Luca Antonioli; Matteo Fornai; Corrado Blandizzi; Marco Tuccori Journal: Drug Saf Date: 2016-10 Impact factor: 5.606
Authors: Bryce A Griffin; Caitlin O Caperton; Lauren N Russell; Christian V Cabanlong; Catheryn D Wilson; Kyle R Urquhart; Bradford S Martins; Marcelle Dina Zita; Amy L Patton; Alexander W Alund; S Michael Owens; William E Fantegrossi; Jeffery H Moran; Lisa K Brents Journal: J Pharmacol Exp Ther Date: 2019-04-26 Impact factor: 4.030
Authors: Stephen W Patrick; Judith Dudley; Peter R Martin; Frank E Harrell; Michael D Warren; Katherine E Hartmann; E Wesley Ely; Carlos G Grijalva; William O Cooper Journal: Pediatrics Date: 2015-04-13 Impact factor: 7.124
Authors: Madelyn H Labella; Rina D Eiden; Alexandra R Tabachnick; Tabitha Sellers; Mary Dozier Journal: Neurotoxicol Teratol Date: 2021-06-08 Impact factor: 4.071