Document Detail


Differences in the profile of neonatal abstinence syndrome signs in methadone- versus buprenorphine-exposed neonates.
MedLine Citation:
PMID:  23106927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To compare the profile of signs of neonatal abstinence syndrome (NAS) in methadone- versus buprenorphine-exposed infants.
DESIGN, SETTING AND PARTICIPANTS: Secondary analysis of NAS data from a multi-site, double-blind, double-dummy, flexible-dosing, randomized clinical trial. Data from a total of 129 neonates born to opioid-dependent women who had been assigned to receive methadone or buprenorphine treatment during pregnancy were examined.
MEASUREMENTS: For 10 days after delivery, neonates (methadone = 72, buprenorphine = 57) were assessed regularly using a 19-item modified Finnegan scale. Data from neonates who required pharmacological treatment (methadone = 41, buprenorphine = 27) were included up to the time treatment was initiated. The incidence and mean severity of the total NAS score and each individual sign of NAS were calculated and compared between medication conditions, as was the median time until morphine treatment initiation among treated infants in each condition.
FINDINGS: Two NAS signs (undisturbed tremors and hyperactive Moro reflex) were observed significantly more frequently in methadone-exposed neonates and three (nasal stuffiness, sneezing, loose stools) were observed more frequently in buprenorphine-exposed neonates. Mean severity scores on the total NAS score and five individual signs (disturbed and undisturbed tremors, hyperactive Moro reflex, excessive irritability, failure to thrive) were significantly higher among methadone-exposed neonates, while sneezing was higher among buprenorphine-exposed neonates. Among treated neonates, methadone-exposed infants required treatment significantly earlier than buprenorphine-exposed infants (36 versus 59 hours postnatal, respectively).
CONCLUSIONS: The profile of neonatal abstinence syndrome differs in methadone- versus buprenorphine-exposed neonates, with significant differences in incidence, severity and treatment initiation time. Overall, methadone-exposed neonates have a more severe neonatal abstinence syndrome.
Authors:
Diann E Gaalema; Teresa Linares Scott; Sarah H Heil; Mara G Coyle; Karol Kaltenbach; Gary J Badger; Amelia M Arria; Susan M Stine; Peter R Martin; Hendrée E Jones
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Addiction (Abingdon, England)     Volume:  107 Suppl 1     ISSN:  1360-0443     ISO Abbreviation:  Addiction     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-30     Completed Date:  2013-10-22     Revised Date:  2014-10-14    
Medline Journal Info:
Nlm Unique ID:  9304118     Medline TA:  Addiction     Country:  England    
Other Details:
Languages:  eng     Pagination:  53-62     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00271219
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MeSH Terms
Descriptor/Qualifier:
Adult
Analgesics, Opioid / administration & dosage,  adverse effects*
Analysis of Variance
Buprenorphine / administration & dosage,  adverse effects*
Double-Blind Method
Female
Humans
Incidence
Infant, Newborn
Methadone / administration & dosage,  adverse effects*
Neonatal Abstinence Syndrome / epidemiology*,  etiology,  physiopathology
Opiate Substitution Treatment
Opioid-Related Disorders / drug therapy*
Pregnancy
Pregnancy Complications / drug therapy
Prenatal Exposure Delayed Effects*
Severity of Illness Index
Symptom Assessment / statistics & numerical data
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
M01 RR 00095/RR/NCRR NIH HHS; M01 RR 109/RR/NCRR NIH HHS; M01 RR000095/RR/NCRR NIH HHS; M01 RR000109/RR/NCRR NIH HHS; R01 DA 015738/DA/NIDA NIH HHS; R01 DA 015741/DA/NIDA NIH HHS; R01 DA 015764/DA/NIDA NIH HHS; R01 DA 015778/DA/NIDA NIH HHS; R01 DA 017513/DA/NIDA NIH HHS; R01 DA 018410/DA/NIDA NIH HHS; R01 DA 018417/DA/NIDA NIH HHS; R01 DA 15832/DA/NIDA NIH HHS; R01 DA015713/DA/NIDA NIH HHS; R01 DA015738/DA/NIDA NIH HHS; R01 DA015741/DA/NIDA NIH HHS; R01 DA015764/DA/NIDA NIH HHS; R01 DA015778/DA/NIDA NIH HHS; R01 DA015832/DA/NIDA NIH HHS; R01 DA018410/DA/NIDA NIH HHS; R01 DA018417/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 40D3SCR4GZ/Buprenorphine; UC6VBE7V1Z/Methadone
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