This meta- analysis showed no significant impairments , at a non-conservative significance level of p < 0.05 , for cognitive , psychomotor or observed behavioural outcomes for chronic intra-uterine exposed infants and pre-school children compared to non-exposed infants and children .
However , all domains suggested a trend to poor outcomes in infants/children of opioid using mothers .
Conclusions Chronic intra-uterine opioid exposed infants and pre-school children experienced no significant impairment in neurobehavioral outcomes when compared to non-exposed peers , although in all domains there was a trend to poorer outcomes .
Background It is assumed within the accumulated literature that children born of pregnant opioid dependent mothers have impaired neurobehavioral function as a consequence of chronic intrauterine opioid use .
Neonatal abstinence syndrome after methadone or buprenorphine exposure.
BACKGROUND Methadone , a full mu-opioid agonist , is the recommended treatment for opioid dependence during pregnancy . However , prenatal exposure to methadone is associated with a neonatal abstinence syndrome ( NAS ) characterized by central nervous system hyperirritability and autonomic nervous system dysfunction , which often requires medication and extended hospitalization . Buprenorphine , a partial mu-opioid agonist , is an alternative treatment for opioid dependence but has not been extensively studied in pregnancy . METHODS We conducted a double-blind , double-dummy , flexible-dosing , r and omized , controlled study in which buprenorphine and methadone were compared for use in the comprehensive care of 175 pregnant women with opioid dependency at eight international sites . Primary outcomes were the number of neonates requiring treatment for NAS , the peak NAS score , the total amount of morphine needed to treat NAS , the length of the hospital stay for neonates , and neonatal head circumference . RESULTS Treatment was discontinued by 16 of the 89 women in the methadone group ( 18 % ) and 28 of the 86 women in the buprenorphine group ( 33 % ) . A comparison of the 131 neonates whose mothers were followed to the end of pregnancy according to treatment group ( with 58 exposed to buprenorphine and 73 exposed to methadone ) showed that the former group required significantly less morphine ( mean dose , 1.1 mg vs. 10.4 mg ; P<0.0091 ) , had a significantly shorter hospital stay ( 10.0 days vs. 17.5 days , P<0.0091 ) , and had a significantly shorter duration of treatment for the neonatal abstinence syndrome ( 4.1 days vs. 9.9 days , P<0.003125 ) ( P values calculated in accordance with prespecified thresholds for significance ) . There were no significant differences between groups in other primary or secondary outcomes or in the rates of maternal or neonatal adverse events . CONCLUSIONS These results are consistent with the use of buprenorphine as an acceptable treatment for opioid dependence in pregnant women . ( Funded by the National Institute on Drug Abuse ; Clinical Trials.gov number , NCT00271219 . )
This meta- analysis showed no significant impairments , at a non-conservative significance level of p < 0.05 , for cognitive , psychomotor or observed behavioural outcomes for chronic intra-uterine exposed infants and pre-school children compared to non-exposed infants and children .
However , all domains suggested a trend to poor outcomes in infants/children of opioid using mothers .
Conclusions Chronic intra-uterine opioid exposed infants and pre-school children experienced no significant impairment in neurobehavioral outcomes when compared to non-exposed peers , although in all domains there was a trend to poorer outcomes .
Background It is assumed within the accumulated literature that children born of pregnant opioid dependent mothers have impaired neurobehavioral function as a consequence of chronic intrauterine opioid use .