Prospective multicenter observational study of 260 infants born to 259 opiate-dependent mothers on methadone or high-dose buprenophine substitution

• Published in: Drug and alcohol dependence Vol. 82; no. 3; pp. 250 - 257
• Main Authors: Lejeune, Claude, Simmat-Durand, Laurence, Gourarier, Laurent, Aubisson, Sandrine
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 20.05.2006; Elsevier Science
• Subjects: Addiction and pregnancy; Addictive behaviors; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Buprenorphine - therapeutic use; Drug addiction; Female; High-dose buprenorphine; HIV Seropositivity - epidemiology; Humans; Infant Care; Infant, Newborn; Infants; Maintenance treatments; Medical sciences; Methadone; Methadone - therapeutic use; Narcotic Antagonists - therapeutic use; Neonatal abstinence syndrome; Opiates; Opioid-Related Disorders - psychology; Opioid-Related Disorders - rehabilitation; Parity; Perinatal Care; Pregnancy; Pregnancy Complications - psychology; Pregnancy Complications - rehabilitation; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Socioeconomic Factors; Substance abuse; Toxicology; Treatment Outcome; Addiction and pregnancy; Methadone; High-dose buprenorphine; Neonatal abstinence syndrome; Maintenance treatments; Human; Drug addiction; Neonatal; Multicenter study; Infant; Opiates; Narcotic analgesic; Abstinence; Syndrome; Pregnancy; Prospective; Newborn; Addiction; Mother; Substitution; Observation; Female; Drug of abuse; High dose
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2005.10.001

Specialized prenatal care and substitution programs improve the perinatal prognoses of pregnant drug-abusers and their infants. Although methadone is well documented, little is known about high-dose buprenorphine (HDB). This prospective, multicenter ( n = 35) observational study included 259 women on maintenance during pregnancy: 39% on methadone and 61% on HDB. Major findings were: 46% of them received good prenatal care; 62% had peridural analgesia; 12.3% delivered prematurely (<37 weeks); mean gestational age, 38.6 weeks; mean birth weight, 2822 g. Three-quarters of the newborns developed neonatal abstinence syndrome (NAS) beginning at a mean age of 40 h, with the mean maximum Lipsitz score of 9.1 at 72 h; half of them were treated, mainly with morphine hydrochloride. No baby died. Newborns were discharged with their mothers (96%) or placed in foster care (4%). Comparing methadone with HDB, respectively, mean age at the maximum Lipsitz score was 81 h versus 66 h ( P = 0.066). The perinatal medical and social prognoses for these 259 drug addicts and their infants appeared to be improved by specialized prenatal care and was similar for methadone or BHD substitution during pregnancy.