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Histological Changes Observed in Placentas Exposed to Medication-Assisted Treatment
Cara Staszewski1, Kimberly M Herrera1, Elizabeth Kertowidjojo2
1Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.
Journal of Pregnancy
|October 18, 2021
Summary
Medication-assisted treatment in pregnant women with opioid use disorder was linked to placental abnormalities, including delayed villous maturation and altered placental weight, and lower birth weights in newborns compared to healthy controls.
Area of Science:
- Obstetrics and Gynecology
- Perinatology
- Pharmacology
Background:
- Opioid use disorder (OUD) in pregnancy presents significant challenges.
- Medication-assisted treatment (MAT) is the standard of care for pregnant women with OUD.
- The effects of MAT on placental development and neonatal outcomes require further investigation.
Purpose of the Study:
- To compare placental characteristics and neonatal outcomes in pregnant women undergoing MAT (buprenorphine or methadone) versus uncomplicated pregnancies.
- To identify specific placental changes associated with MAT during pregnancy.
Main Methods:
- Case-controlled study matching MAT pregnancies to healthy controls by gestational age.
- Placental evaluations included villous maturation, placental weight, and fetoplacental weight ratio.
- Neonatal outcomes, primarily birth weight, were assessed. Statistical analysis included relative risk.
Main Results:
- MAT pregnancies (n=103) showed a higher incidence of delayed villous maturation (36% vs. 10% in controls).
- Placentas in MAT pregnancies were heavier (541g vs. 491g) with a lower fetoplacental weight ratio (5.70 vs. 7.13).
- MAT newborns had significantly lower birth weights (3018g vs. 3380g), with methadone-exposed infants having lower weights than buprenorphine-exposed infants.
Conclusions:
- MAT is associated with increased delayed villous maturation, larger placental size, and reduced fetoplacental weight ratio.
- Neonatal birth weight is significantly reduced in MAT pregnancies.
- Further long-term studies are needed to assess outcomes related to delayed villous maturation in these pregnancies.
