Document Type
Article
Publication Date
6-23-2016
Description
Background
Buprenorphine is a semi-synthetic opioid used for the treatment of opioid dependence. Opioid use, including buprenorphine, has been increasing in recent years, in the general population and in pregnant women. Consequently, there has been a rise in frequency of neonatal abstinence syndrome (NAS), associated with buprenorphine use during pregnancy. The purpose of this study was to investigate correlations between buprenorphine and buprenorphine-metabolite concentrations in cord blood and onset of NAS in buprenorphine exposed newborns.
Methods
Nineteen (19) newborns who met inclusion criteria were followed after birth until discharge in a double-blind non-intervention study, after maternal consent. Cord blood and tissue samples were collected and analyzed by liquid chromatography–mass spectrometry (LC–MS) for buprenorphine and metabolites. Simple and multiple logistic regressions were used to examine relationships between buprenorphine and buprenorphine metabolite concentrations in cord blood and onset of NAS, need for morphine therapy, and length of stay.
Results
Each increase in 5 ng/ml level of norbuprenorphine in cord blood increases odds of requiring treatment by morphine 2.5 times. Each increase in 5 ng/ml of buprenorphine-glucuronide decreases odds of receiving morphine by 57.7 %. Along with concentration of buprenorphine metabolites, birth weight and gestational age also play important roles, but not maternal buprenorphine dose.
Conclusions
LC–MS analysis of cord blood concentrations of buprenorphine and metabolites is an effective way to examine drug and metabolite levels in the infant at birth. Cord blood concentrations of the active norbuprenorphine metabolite and the inactive buprenorphine-glucuronide metabolite show promise in predicting necessity of treatment of NAS. These finding have implications in improving patient care and reducing healthcare costs if confirmed in a larger sample.
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This work is licensed under a Creative Commons Attribution 4.0 International License.
Citation Information
Shah, Darshan; Brown, Stacy; Hagemeier, Nick; Zheng, Shimin; Kyle, Amy; Pryor, Jason; Dankhara, Nilesh; and Singh, Piyuesh. 2016. Predictors of Neonatal Abstinence Syndrome in Buprenorphine Exposed Newborn: Can Cord Blood Buprenorphine Metabolite Levels Help?. SpringerPlus. Vol.5(1). 854. https://doi.org/10.1186/s40064-016-2576-8 ISSN: 2193-1801
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Biostatistics Commons, Maternal and Child Health Commons, Pharmacy and Pharmaceutical Sciences Commons, Substance Abuse and Addiction Commons
Copyright Statement
© 2016 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.