Infections and obstetric outcomes in opioid-dependent pregnant women maintained on methadone or buprenorphine
Amber M Holbrook, Jason K Baxter, Hendrée E Jones, Sarah H Heil, Mara G Coyle, Peter R Martin, Susan M Stine, Karol Kaltenbach, Amber M Holbrook, Jason K Baxter, Hendrée E Jones, Sarah H Heil, Mara G Coyle, Peter R Martin, Susan M Stine, Karol Kaltenbach
Abstract
Aims: To characterize infections and compare obstetric outcomes in opioid-dependent pregnant women who participated in a randomized clinical trial comparing agonist medications, methadone and buprenorphine.
Design: Incidence of infections was identified as part of the screening medical assessment. As part of a planned secondary analysis, analysis of variance and polytomous logistic regressions were conducted on obstetric outcome variables using treatment randomization condition (maternal maintenance with either methadone or buprenorphine) as the predictor variable, controlling for differences between study sites.
Setting: Six United States sites and one European site that provided comprehensive treatment to opioid-dependent pregnant women.
Participants: Pregnant opioid-dependent women (n = 131) who delivered while participating in the Maternal Opioid Treatment: Human Experimental Research (MOTHER) study.
Measurements: Obstetric, infectious and other maternal medical complications captured by medical records, physical examination, blood tests and self-report. Neonatal medical complications captured by medical records.
Findings: Hepatitis C was the most common infection (32.3%), followed by hepatitis B (7.6%) and chlamydia (6.1%) among participants at study enrollment. Maternal methadone versus buprenorphine maintenance was associated with a higher incidence of preterm labor (P = 0.04) and a significantly higher percentage of signs of respiratory distress in neonates at delivery (P = 0.05). Other medical and obstetric complications were infrequent in the total sample, as well as in both methadone and buprenorphine conditions.
Conclusions: Buprenorphine appears to have an acceptable safety profile for use during pregnancy.
Trial registration: ClinicalTrials.gov NCT00271219.
Conflict of interest statement
Declaration of interests:
The clinical trial was registered with ClinicalTrials.gov (Identifier: NCT00271219; Title: RCT Comparing Methadone and Buprenorphine in Pregnant Women).
H.J. discloses that she has received reimbursement for time and travel from Reckitt Benckiser.
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.
Source: PubMed