|Titre :||Buprenorphine treatment of opioid-dependent pregnant women: a comprehensive review (2012)|
|Auteurs :||H. E. JONES ; S. H. HEIL ; A. BAEWERT ; A. M. ARRIA ; K. KALTENBACH ; P. R. MARTIN ; M. G. COYLE ; P. SELBY ; G. FISCHER|
|Type de document :||Article : Périodique|
|Dans :||Addiction (Vol.107, Suppl.1, November 2012)|
|Article en page(s) :||5-27|
|Discipline :||TRA (Traitement et prise en charge / Treatment and care)|
Thésaurus TOXIBASESEXE FEMININ ; GROSSESSE ; OPIOIDES ; MERE ; EFFICACITE ; TRAITEMENT ; TRAITEMENT DE MAINTENANCE ; BUPRENORPHINE ; METHADONE ; COMPARAISON ; SUBSTITUTION ; NOUVEAU-NE ; SYNDROME DE SEVRAGE ; ALLAITEMENT ; CROISSANCE
Aims: This paper reviews the published literature regarding outcomes following maternal treatment with buprenorphine in five areas: maternal efficacy, fetal effects, neonatal effects, effects on breast milk and longer-term developmental effects.
Methods: Within each outcome area, findings are summarized first for the three randomized clinical trials and then for the 44 non-randomized studies (i.e. prospective studies, case reports and series and retrospective chart reviews), only 28 of which involve independent samples.
Results: Results indicate that maternal treatment with buprenorphine has comparable efficacy to methadone, although difficulties may exist with current buprenorphine induction methods. The available fetal data suggest buprenorphine results in less physiological suppression of fetal heart rate and movements than methadone. Regarding neonatal effects, perhaps the single definitive conclusion is that prenatal buprenorphine treatment results in a clinically significant less severe neonatal abstinence syndrome (NAS) than treatment with methadone. The limited research suggests that, like methadone, buprenorphine is compatible with breastfeeding. Data available thus far suggest that there are no deleterious effects of in utero buprenorphine exposure on infant development.
Conclusions: While buprenorphine produces a less severe neonatal abstinence syndrome than methadone, both methadone and buprenorphine are important parts of a complete comprehensive treatment approach for opioid-dependent pregnant women.
|Domaine :||Autres substances / Other substances ; Drogues illicites / Illicit drugs|
|Sous-type de document :||Revue de la littérature / Literature review|
|Refs biblio. :||89|
|Affiliation :||Departments of Psychiatry and Behavioral Sciences and Obstetrics and Gynecology, Johns Hopkins University School of Medicine, Baltimore, MD, USA|