Buprenorphine versus methadone in pregnant opioid-dependent women: a prospective multicenter study

  • Isabelle Lacroix
  • Alain Berrebi
  • Daniel Garipuy
  • Laurent Schmitt
  • Yamina Hammou
  • Catherine Chaumerliac
  • Maryse Lapeyre-Mestre
  • Jean-Louis Montastruc
  • Christine Damase-Michel
Pharmacoepidemiology and Prescription

Abstract

Patients and methods

In order to investigate the effects of exposure to buprenorphine compared with methadone during pregnancy, a prospective multicenter study was conducted in collaboration with maternity hospitals, maintenance therapy centers, and general practitioners involved in addiction care. Ninety pregnant women exposed to buprenorphine and 45 to metadone were selected for the study.

Results

During pregnancy, some women were exposed to illicit agents: cannabis (42% in the buprenorphine group vs. 58% in the methadone-treated group), heroin (17% vs. 44%), or cocaine (3% vs. 11%). Pregnancies ended in 85 vs. 40 live births, one vs. two stillbirths, two vs. one spontaneous abortion, two vs. one voluntary termination, and one vs. one medical termination in the buprenorphine and the methadone groups, respectively. Newborns had a birth weight of 2,892 ± 506 g (buprenorphine) vs. 2,731 ± 634 g (methadone) and a body length of 47.6 ± 2.5 cm vs. 47.1 ± 3 cm. 18.8% vs. 10% of newborns were delivered before 37 weeks of amenorrhea. Neonatal withdrawal syndrome occurred more frequently in the methadone group (62.5% vs. 41.2, p = 0.03). After adjustment for heroin exposure in late pregnancy, rates of neonatal withdrawal were no longer different between the methadone and buprenorphine groups. Twenty-one babies (84%) in the methadone group and 20 (57%) in the buprenorphine group (p = 0.03) required opiate treatment.

Conclusions

We did not observe more frequent malformations or cases of withdrawal syndrome in the buprenorphine group than in the methadone-treated group. Buprenorphine appears to be as safe as the currently approved substitute methadone considered to date as the reference treatment for pregnant opioid-dependent women.

Keywords

Pregnancy Buprenorphine Methadone Neonate Neonatal withdrawal Pharmacoepidemiology 

Notes

Acknowledgement

The authors thank Mariana Titorov for her editorial assistance, Dr. Catherine Alexandre, Evelyne Armand, Dr. Jacques Barsony, Dr. Bernard Beauséjour, Dr. Charles Bensehmoun, Dr. Jérôme Boucard, Dr. Philippe Cadilhac, Dr. Hélène Charitat, Dr. Marie Crecqui, Dr. Philippe De Lapanouse, Dr. Elisabeth Elefant, Dr. Valérie Fuzier, Dr. André Glibert, Dr. Jérôme Heysch de la Borde, Dr. Marie-Annick Lebreton, Dr. Nadir Messaadi, Dr. Georges Noujaïm, Dr. Olivier Parant, Dr. Jean-Yves Redon, Dr. Francis Saint-Dizier, Martine Segueilla, and Catherine Wahart for their participation (inclusion of pregnant women). With the support of the French Programme Hospitalier de Recherche Clinique.

Declarations of interest

None

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Isabelle Lacroix
    • 1
  • Alain Berrebi
    • 2
  • Daniel Garipuy
    • 3
  • Laurent Schmitt
    • 4
  • Yamina Hammou
    • 5
  • Catherine Chaumerliac
    • 6
  • Maryse Lapeyre-Mestre
    • 1
  • Jean-Louis Montastruc
    • 7
  • Christine Damase-Michel
    • 7
  1. 1.Centre Hospitalier Universitaire de Toulouse, Laboratoire de Pharmacologie Médicale et Clinique, Centre d’Evaluation et d’Information sur la Pharmacodépendance et d’AddictovigilanceINSERM U1027, Université de ToulouseToulouseFrance
  2. 2.Service de Gynécologie ObstétriqueCentre Hospitalier Universitaire de ToulouseToulouseFrance
  3. 3.Hôpital Joseph Ducuing, Réseau ville-hôpital PassageToulouseFrance
  4. 4.Centre Hospitalier Universitaire de Toulouse, Centre de soins aux toxicomanesToulouseFrance
  5. 5.Service de Gynécologie ObstétriqueCentre Hospitalier Universitaire de LilleToulouseFrance
  6. 6.Laboratoire de Pharmacologie Médicale et CliniqueCentre Hospitalier Universitaire de ToulouseToulouseFrance
  7. 7.Centre Hospitalier Universitaire de Toulouse, Laboratoire de Pharmacologie Médicale et CliniqueINSERM U1027, Université de ToulouseToulouseFrance

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