Neonatal outcome following buprenorphine maintenance during conception and throughout pregnancy

FRANÇAIS :
Etude de cas de deux nouveau-nés de patientes en traitement de maintenance à la buprénorphine : le syndrome de sevrage néonatal est plus faible qu'avec la méthadone, et la prise de buprénorphine n'a pas eu de conséquences sur le grossesse, l'accouchement de la mère, ni sur le poids et le développement neurologique de l'enfant.
ENGLISH :
Aims. To assess the effects of maternal buprenorphine treatment at conception and during pregnancy on neonates in terms of birth outcomes and neonatal abstinence syndrome (NAS). Design and setting. Prospective, open-label, out-patient maintenance, case report study, conducted at the drug addiction out-patient clinic at the University Hospital Vienna. Participants. Two buprenorphine-maintained pregnant women who had conceived during buprenorphine treatment. Both patients had previously given birth to healthy neonates following induction on to buprenorphine maintenance therapy in the second trimester. Measurements. Mothers: urinalysis. Neonates: gestational age at delivery. Apgar scores, birth weight, length and NAS (Finnegan Scale). Findings. Urinalyses were negative for both women for 25 and 38 months, respectively, during the pregnancy period. There were no complications during the course of the pregnancy. The newborns delivered by both women were healthy, birth outcomes were within normal ranges and there were no NAS symptoms requiring treatment. Conclusions. To our knowledge this is the first report detailing the pregnancies of women treated with buprenorphine at the time of conception and investigated in a prospective study. The NAS noted in neonates born to buprenorphine-maintained mothers appears to be less severe than the NAS observed in neonates born to methadone-maintained mothers. These preliminary data indicate that, in our patient cohort, buprenorphine maintenance at the time of conception and during pregnancy did not seem to affect birth outcome measurements such as pregnancy complications, week of delivery, birth weight, length, umbilical pH or neurodevelopmental progress. Future prospective studies with larger study populations are warranted. (Editor' s abstract)