Buprenorphine in pregnant opiod-dependant women : first results of a prospective study

FRANÇAIS :
Sur trente quatre femmes suivies, on a observé 31 naissances normales, une naissance prématurée, un avortement spontané et une interruption volontaire de grossesse. Il y a eu 13 cas de syndrome de sevrage néonatal dont 8 ont nécessité un traitement aux opiacés. Deux enfants ont présenté une malformation. Comparativement à d'autres études ces résultats ne présentent aucun signe alarmant.
ENGLISH :
Aim: To report results on the prospective follow-up of 34 pregnant women exposed to buprenorphine maintenance for opiate dependence. Design and setting: Prospective multicentre study : all pregnant women receiving buprenorphine as maintenance therapy were included as early as possible during their pregnancy. Participants: The pregnant women were recruited from opiate maintenance therapy centres, general practitioner-networks involved in addiction, maternity hospitals and centres for drug information during pregnancy. Measurements: Women : drugs and medications consumed, medical and obstetrical events ; offspring: withdrawal syndrome, malformation, neonatal disease. Findings: The buprenorphine-exposed pregnancies resulted in 31 live births, one stillbirth, one spontaneous abortion and one voluntary termination. A neonatal withdrawal svndrome was observed in 13 cases (41.9%) and eight of these babies required opiate treatment. Two neonates had a malformation: a premature ductus arteriosus stricture and a tragus appendix. Conclusion: Taken together with other prospective studies, no alarming results were observed concerning pregnancy outcomes. However, further data from the comparative prospective study are required to determine whether buprenorphine can be considered as a good alternative to methadone treatment in pregnant women. (Review' s abstract)