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Methadone and Buprenorphine for Opioid Dependence During Pregnancy: A Retrospective Cohort Study

Meyer, Marjorie C. MD; Johnston, Anne M. MD; Crocker, Abigail M. PhD; Heil, Sarah H. PhD

doi: 10.1097/ADM.0000000000000092
Original Research
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Objectives: To compare maternal characteristics, prenatal care, and newborn outcomes in a cohort of opioid-dependent pregnant women treated with methadone versus buprenorphine.

Methods: In a retrospective cohort study, 609 pregnant, opioid-dependent women were treated with methadone (n = 248) or buprenorphine (n = 361) between 2000 and 2012 at a single institution.

Results: Mothers treated with buprenorphine were more likely to start medication before or earlier in pregnancy, had longer gestation, and gave birth to larger infants. Newborns of buprenorphine- versus methadone-maintained mothers required treatment for neonatal abstinence significantly less often and for a shorter duration.

Conclusions: These data suggest pregnancy outcomes with buprenorphine to treat opioid dependence during pregnancy in clinical practice are as good and often better than outcomes with methadone. These results are consistent with efficacy data from randomized clinical trials and further support the use of buprenorphine for the treatment of opioid dependence during pregnancy.

From the Department of Obstetrics, Gynecology and Reproductive Sciences (MCM), Department of Pediatrics (AMJ), Department of Mathematics and Statistics (AMC), and Departments of Psychiatry and Psychology (SHH), University of Vermont, Burlington, VT.

Send correspondence and reprint requests to Marjorie C. Meyer, MD, Smith 419, MCHV Campus, 111 Colchester Ave, Burlington, VT 05401. E-mail: Marjorie.Meyer@uvm.edu.

Supported in part by R34Da030534 and R01 DA031928 from the National Institute on Drug Abuse. Support for maintenance of the Quality Assurance data was provided by the Vermont Child Health Improvement Program. Neither NIH nor VCHIP had any further role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

The authors declare no conflicts of interest.

Received July 01, 2014

Accepted September 26, 2014

© 2015 American Society of Addiction Medicine