Document Detail


Fetal assessment before and after dosing with buprenorphine or methadone.
MedLine Citation:
PMID:  23106925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To determine pre- and post-dosing effects of prenatal methadone compared to buprenorphine on fetal wellbeing.
DESIGN: A secondary analysis of data derived from the Maternal Opioid Treatment: Human Experimental Research (MOTHER) study, a double-blind, double-dummy, randomized clinical trial.
SETTING: Six United States sites and one European site that provided comprehensive opioid-dependence treatment to pregnant women.
PARTICIPANTS: Eighty-one of the 131 opioid-dependent pregnant women completing the MOTHER clinical trial, assessed between 31 and 33 weeks of gestation.
MEASUREMENTS: Two fetal assessments were conducted, once before and once after study medication dosing. Measures included mean fetal heart rate (FHR), number of FHR accelerations, FHR reactivity in the fetal non-stress test (NST) and biophysical profile (BPP) score.
FINDINGS: Significant group differences were found for number of FHR accelerations, non-reactive NST and BPP scores (all Ps < 0.05). There were no significant group differences before time of dosing. Significant decreases (all Ps < 0.05) occurred from pre- to post-dose assessment for mean FHR, FHR accelerations, reactive NST and fetal movement. The decrease in accelerations and reactive NST were significant only for fetuses in the methadone group, and this resulted in a significantly lower likelihood of a reactive NST compared to fetuses in the buprenorphine group.
CONCLUSION: Buprenorphine compared with methadone appears to result in less suppression of mean fetal heart rate, fetal heart rate reactivity and the biophysical profile score after medication dosing and these findings provide support for the relative safety of buprenorphine when fetal indices are considered as part of the complete risk-benefit ratio.
Authors:
Amy L Salisbury; Mara G Coyle; Kevin E O'Grady; Sarah H Heil; Peter R Martin; Susan M Stine; Karol Kaltenbach; Manfred Weninger; 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:  2014-05-16    
Medline Journal Info:
Nlm Unique ID:  9304118     Medline TA:  Addiction     Country:  England    
Other Details:
Languages:  eng     Pagination:  36-44     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:
Adolescent
Adult
Analgesics, Opioid / pharmacology,  therapeutic use*
Biophysical Processes / drug effects
Buprenorphine / pharmacology,  therapeutic use*
Double-Blind Method
Female
Fetal Monitoring / methods
Fetal Movement / drug effects
Fetus / drug effects
Gestational Age
Heart Rate, Fetal / drug effects*
Humans
Infant, Newborn
Methadone / pharmacology,  therapeutic use*
Opiate Substitution Treatment*
Opioid-Related Disorders / drug therapy*,  rehabilitation
Outcome Assessment (Health Care) / methods
Pregnancy
Pregnancy Complications / drug therapy,  rehabilitation
Young Adult
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 DA015764/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 40D3SCR4GZ/Buprenorphine; UC6VBE7V1Z/Methadone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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