Opioid agonist therapy in pregnant women, buprenorphine vs. methadone
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Reviewed by Dat Tien Nguyen, B.A, ScM.
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Posted on December 2nd, 2022
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For pregnant women who are using opioids, to manage pain, opioid agonist therapy is usually initiated concurrently. This improves adherence to prenatal care and reduces the incidence of preterm birth, overdose, and death. Methadone and buprenorphine are the two commonly used opioid agonists; a recent study had compared their effect on maternal and fetal health.
The nationwide retrospective observational study uses the Medicaid database collected from 2000 to 2008. A total of 31,419 pregnant women who were under opioid agonist therapy were included in the analysis; 21,976 of them used buprenorphine, and 9,443 of them used methadone. Neonatal abstinence syndrome is observed in 52% of the buprenorphine group; this is significantly lower than the 69.2% observed in the methadone group. This indicates that buprenorphine is more effective at reducing the dependence influence of the opioid. Fetuses of mothers who used methadone tend to be smaller than their gestational age, and the risk of preterm birth is 10.5% higher than those who were treated with buprenorphine. Also, the percentage of neonates with low birth weight is 6.6% higher in the methadone group compared to buprenorphine. However, there is no difference in the risk of severe maternal complication and cesarean delivery between the two groups.
The nationwide retrospective observational study uses the Medicaid database collected from 2000 to 2008. A total of 31,419 pregnant women who were under opioid agonist therapy were included in the analysis; 21,976 of them used buprenorphine, and 9,443 of them used methadone. Neonatal abstinence syndrome is observed in 52% of the buprenorphine group; this is significantly lower than the 69.2% observed in the methadone group. This indicates that buprenorphine is more effective at reducing the dependence influence of the opioid. Fetuses of mothers who used methadone tend to be smaller than their gestational age, and the risk of preterm birth is 10.5% higher than those who were treated with buprenorphine. Also, the percentage of neonates with low birth weight is 6.6% higher in the methadone group compared to buprenorphine. However, there is no difference in the risk of severe maternal complication and cesarean delivery between the two groups.