NICU Admission Rate Is Lower With Low Dose Buprenorphine + Naloxone Medication Assisted Treatment

Authors' Affiliations

Nicole Lewis, PhD Associate Professor, Department of Medical Education, East Tennessee State University James H. Quillen College of Medicine Johnson City, TN

Location

D.P. Culp Center Ballroom

Start Date

4-5-2024 9:00 AM

End Date

4-5-2024 11:30 AM

Poster Number

57

Name of Project's Faculty Sponsor

Martin Olsen

Faculty Sponsor's Department

Obstetrics and Gynecology

Classification of First Author

Clinical Doctoral Student

Competition Type

Competitive

Type

Poster Presentation

Presentation Category

Health

Abstract or Artist's Statement

Introduction: There has been a tenfold rise in the incidence of infants born with NAS in Tennessee. These babies stay in the hospital longer and could have serious medical and social problems. Combination buprenorphine + naloxone therapy has not been evaluated for treatment of Opioid Use Disorder (OUD) in pregnancy despite having a lower misuse and diversion potential than the current standards of care (methadone or buprenorphine). The goal of this study was to determine if combination buprenorphine + naloxone therapy is a safer alternative for OUD in pregnancy by evaluating differences in neonatal outcomes in four groups. Methods: The 4 groups of mothers and infants reviewed were: 1- Mothers treated with mono-buprenorphine in our ETSU MAT clinic, 2- Mothers treated with combination buprenorphine + naloxone in our clinic, 3- Mothers receiving prenatal care from our clinic but receiving mono-buprenorphine from an outside MAT clinic, and 4-Mothers receiving prenatal care from our clinic but receiving combination buprenorphine + naloxone from an outside clinic. We compared neonatal and maternal outcomes of each group (Table 1). Results: The combination therapy groups have a significantly lower proportion of NICU admissions than the mono therapy groups (p-value = 0.02789). Also, the proportion of NICU admissions is significantly less for infants whose mothers are on a buprenorphine dose of 0-2 mg than those whose mothers are on a dose of 8 mg (p-value = 0.005607). Additional results are pending further data analysis. Conclusions: Given these results, we can conclude that women who were treated with combination therapy for OUD in pregnancy were associated with a significantly lower proportion of NICU admissions for their infants than those treated with mono therapy. Moreover, a lower final buprenorphine dose was associated with both a higher proportion of clean infant UDS’s and a lower proportion of NICU admissions. These results indicate that combination therapy and tapered doses of buprenorphine could be associated with better neonatal outcomes.

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Apr 5th, 9:00 AM Apr 5th, 11:30 AM

NICU Admission Rate Is Lower With Low Dose Buprenorphine + Naloxone Medication Assisted Treatment

D.P. Culp Center Ballroom

Introduction: There has been a tenfold rise in the incidence of infants born with NAS in Tennessee. These babies stay in the hospital longer and could have serious medical and social problems. Combination buprenorphine + naloxone therapy has not been evaluated for treatment of Opioid Use Disorder (OUD) in pregnancy despite having a lower misuse and diversion potential than the current standards of care (methadone or buprenorphine). The goal of this study was to determine if combination buprenorphine + naloxone therapy is a safer alternative for OUD in pregnancy by evaluating differences in neonatal outcomes in four groups. Methods: The 4 groups of mothers and infants reviewed were: 1- Mothers treated with mono-buprenorphine in our ETSU MAT clinic, 2- Mothers treated with combination buprenorphine + naloxone in our clinic, 3- Mothers receiving prenatal care from our clinic but receiving mono-buprenorphine from an outside MAT clinic, and 4-Mothers receiving prenatal care from our clinic but receiving combination buprenorphine + naloxone from an outside clinic. We compared neonatal and maternal outcomes of each group (Table 1). Results: The combination therapy groups have a significantly lower proportion of NICU admissions than the mono therapy groups (p-value = 0.02789). Also, the proportion of NICU admissions is significantly less for infants whose mothers are on a buprenorphine dose of 0-2 mg than those whose mothers are on a dose of 8 mg (p-value = 0.005607). Additional results are pending further data analysis. Conclusions: Given these results, we can conclude that women who were treated with combination therapy for OUD in pregnancy were associated with a significantly lower proportion of NICU admissions for their infants than those treated with mono therapy. Moreover, a lower final buprenorphine dose was associated with both a higher proportion of clean infant UDS’s and a lower proportion of NICU admissions. These results indicate that combination therapy and tapered doses of buprenorphine could be associated with better neonatal outcomes.