Treating women with opioid use disorder during pregnancy in Appalachia: Initial neonatal outcomes following buprenorphine + naloxone exposure

Background and Objectives—Rising concerns regarding diversion and misuse of monobuprenorphine for treatment of pregnant women with opioid use disorders have sparked interest in the use of buprenorphine +naloxone to reduce misuse and diversion rates. Examined the relationship of prenatal buprenorphine +naloxone exposure to neonatal outcomes. Methods—This is a retrospective chart review of 26 mother infant dyads in comprehensive medication-assisted treatment with buprenorphine +naloxone during pregnancy. Results—All neonatal birth outcome parameters were within normal ranges, albeit on the lower side of normal for gestational age and birth weight. Only 19% of neonates required morphine pharmacology for NAS. Conclusions—Use of buprenorphine +naloxone shows relative safety in pregnancy. Scientific Significance—These findings can help better guide prescribing practices for pregnant patients at risk for misuse or diversion of buprenorphine