Document Detail


Neonatal neurobehavior effects following buprenorphine versus methadone exposure.
MedLine Citation:
PMID:  23106928     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To determine the effects of in utero exposure to methadone or buprenorphine on infant neurobehavior.
DESIGN: Three sites from the Maternal Opioid Treatment: Human Experimental Research (MOTHER) study, a double-blind, double-dummy, randomized clinical trial participated in this substudy.
SETTING: Medical Centers that provided comprehensive maternal care to opioid-dependent pregnant women in Baltimore, MD, Providence, RI and Vienna, Austria.
PARTICIPANTS: Thirty-nine full-term infants.
MEASUREMENTS: The Neonatal Intensive Care Unit (NICU) Network Neurobehavioral Scale (NNNS) was administered to a subgroup of infants on postpartum days 3, 5, 7, 10, 14-15 and 28-30.
FINDINGS: While neurobehavior improved for both medication conditions over time, infants exposed in utero to buprenorphine exhibited fewer stress-abstinence signs (P < 0.001), were less excitable (P < 0.001) and less over-aroused (P < 0.01), exhibited less hypertonia (P < 0.007), had better self-regulation (P < 0.04) and required less handling (P < 0.001) to maintain a quiet alert state relative to in utero methadone-exposed infants. Infants who were older when they began morphine treatment for withdrawal had higher self-regulation scores (P < 0.01), and demonstrated the least amount of excitability (P < 0.02) and hypertonia (P < 0.02) on average. Quality of movement was correlated negatively with peak NAS score (P < 0.01), number of days treated with morphine for NAS (P < 0.01) and total amount of morphine received (P < 0.03). Excitability scores were related positively to total morphine dose (P < 0.03).
CONCLUSION: While neurobehavior improves during the first month of postnatal life for in utero agonist medication-exposed neonates, buprenorphine exposure results in superior neurobehavioral scores and less severe withdrawal than does methadone exposure.
Authors:
Mara G Coyle; Amy L Salisbury; Barry M Lester; Hendrée E Jones; Hai Lin; Klaudia Graf-Rohrmeister; Gabriele Fischer
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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:  63-73     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 / adverse effects*
Buprenorphine / adverse effects*
Female
Humans
Infant Behavior / drug effects*
Infant, Newborn
Linear Models
Male
Methadone / adverse effects*
Morphine / administration & dosage,  therapeutic use
Neonatal Abstinence Syndrome / drug therapy,  physiopathology*
Opiate Substitution Treatment
Opioid-Related Disorders / drug therapy*
Pregnancy
Pregnancy Complications / drug therapy
Prenatal Exposure Delayed Effects
Severity of Illness Index
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; 76I7G6D29C/Morphine; UC6VBE7V1Z/Methadone

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


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