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Neurobehavioral outcomes of infants exposed to buprenorphine-naloxone compared with naltrexone during pregnancy.

Neurobehavioral outcomes of infants exposed to buprenorphine-naloxone compared with naltrexone during pregnancy.

Authors :
Mantri S
Cheng AC
Saia K
Shrestha H
Amgott R
Bressler J
Werler MM
Carter G
Jones HE
Wachman EM
Source :
Early human development [Early Hum Dev] 2024 Jul; Vol. 194, pp. 106051. Date of Electronic Publication: 2024 May 21.
Publication Year :
2024

Abstract

Background: Naltrexone is a medication used to treat both opioid and alcohol use disorder with limited experience in pregnant individuals, particularly in comparison to more commonly utilized treatments such as buprenorphine-naloxone. The long-term outcomes of infants exposed to naltrexone has not been previously examined.<br />Aims: To compare the neurobehavioral outcomes of naltrexone versus buprenorphine-naloxone exposed infants.<br />Study Design: Multi-centered prospective cohort study.<br />Subjects: Pregnant people on prescribed buprenorphine-naloxone or naltrexone were enrolled during pregnancy and the dyad followed until 12 months after delivery.<br />Outcome Measures: Infants were evaluated at 4-6 weeks corrected gestational age (CGA) using the NICU Neonatal Neurobehavioral Scale (NNNS) and at the 12-month CGA visit using the Ages and Stages Questionnaire, Third Edition (ASQ-3).<br />Results: There were 7 dyads in the naltrexone group and 34 in the buprenorphine-naloxone group. On the NNNS, infants exposed to naltrexone had higher median scores for arousal and excitability, and lower median scores for attention and regulation at 4-6 weeks CGA compared to the buprenorphine-naloxone group. None of the infants in the naltrexone group were monitored for NOWS and had shorter length of hospital stay compared with the buprenorphine-naloxone group. Although no statistically significant differences were observed, more infants in the buprenorphine-naloxone group were identified as at risk for development delays in the communication, problem solving, and personal social domains of the ASQ-3 at 12 months CGA. Results should be interpreted with caution given this study's small sample size and lack of a prospective comparison cohort.<br />Conclusions: In this small cohort, there are differences noted in infant neurobehavior by NNNS at 4-6 weeks of age when comparing the buprenorphine-naloxone and naltrexone groups. At 12 months, ASQ-3 scores were similar but with percentage differences in potential development delay risk observed between the two groups. Larger cohort studies are needed to determine the long-term child outcomes after naltrexone exposure in pregnancy.<br />Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose.<br /> (Copyright © 2024. Published by Elsevier B.V.)

Details

Language :
English
ISSN :
1872-6232
Volume :
194
Database :
MEDLINE
Journal :
Early human development
Publication Type :
Academic Journal
Accession number :
38815498
Full Text :
https://doi.org/10.1016/j.earlhumdev.2024.106051