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[Buprenorphine in pregnancy].

H Eder1, I Rupp, A Peternell

  • 1Drogenambulanz, Klinische Abteilung für Allgemeine Psychiatrie, Universitätsklinik für Psychiatrie, AKH Wien, Germany. gabriele.fischer@akh-wien.ac.at

Psychiatrische Praxis
|September 5, 2001
PubMed
Summary
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Buprenorphine maintenance therapy is a safe and effective option for pregnant women with opioid dependence. This treatment resulted in healthy newborns without neonatal abstinence syndrome (NAS).

Area of Science:

  • Obstetrics and Gynecology
  • Pharmacology
  • Neonatology

Background:

  • Opioid dependence during pregnancy poses significant risks to mother, fetus, and neonate.
  • Methadone is the current guideline-recommended synthetic opioid for managing pregnant patients.
  • Neonatal Abstinence Syndrome (NAS) affects 60-80% of neonates exposed to opioids in utero, with varying severity.

Observation:

  • A case study of a 22-year-old opioid-dependent woman maintained on buprenorphine for 3 years.
  • The patient delivered two healthy newborns during her treatment episode.
  • Neither newborn exhibited symptoms of Neonatal Abstinence Syndrome (NAS).

Findings:

  • Buprenorphine maintenance therapy demonstrated safety and efficacy in this pregnant patient.

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  • The mother remained free of illicit opioid abuse, confirmed by urine toxicology.
  • Buprenorphine's partial mu-receptor agonist and kappa-antagonist profile may explain reduced NAS severity compared to methadone or heroin.

    • Implications:

    • Buprenorphine represents a potentially safer alternative for managing opioid dependence in pregnancy.
    • Further research into buprenorphine's role in reducing NAS is warranted.
    • This approach supports improved maternal and neonatal outcomes in opioid-dependent pregnancies.