Marc Besnier, Marion Delouche, François Birault, Lakshmipriya Lebonheur
University of Poitiers, Poitiers, France.
Am J Addict. 2025 Jan;34(1):15-20. doi: 10.1111/ajad.13652. Epub 2024 Sep 29.
Neonatal opioid withdrawal syndrome (NOWS) is a drug withdrawal syndrome occurring mainly after in utero opioid exposure. Buprenorphine is commonly used for opioid withdrawal. Studies are conflicted about a potential dose effect OBJECTIVE: The aim of our study was to investigate the impact of buprenorphine maternal maintenance therapy on the NOWS based on NOWS duration, birth weight and therapy.
We conducted a retrospective study analysing data from infants admitted for NOWS in two Neonatal Intensive Care Unit between January 2010 and December 2020.
Nonpreterm infants born to mothers who were treated with buprenorphine or therapy during pregnancy and who had a Lipsitz score of 4 or higher.
A total of 75 term newborns were hospitalized for the treatment of NOWS from mother substituted with buprenorphine during the study inclusion period. The duration of NOWS differed significantly between all dose cohorts, with higher doses of maternal buprenorphine maintenance correlating with longer length of NOWS duration. Infants exposed to high doses required 17 days [10; 23], while infants exposed to intermediate doses required 7 days [2; 16] and infants exposed to low doses required 3 days [2; 5], with p-values < .003. Infants exposed to high doses required a longer time to regain their birth weight and higher morphine doses as therapy compared to others. Infants exposed to low doses, intermediate doses, and high doses of buprenorphine demonstrated dose-dependent increases in the durations of hospitalization, respectively.
Increased doses of maternal buprenorphine during pregnancy are correlated with NOWS severity. Our study shows that increased doses of maternal buprenorphine during pregnancy are correlated with NOWS severity. Exploring low doses and having different ranges are a new argument to define the impact of maternal buprenorphine consumption.
新生儿阿片类药物戒断综合征（NOWS）是一种主要发生在子宫内接触阿片类药物后的药物戒断综合征。丁丙诺啡常用于阿片类药物戒断治疗。关于潜在的剂量效应，研究结果存在冲突。目的：我们研究的目的是基于NOWS持续时间、出生体重和治疗情况，调查丁丙诺啡母体维持治疗对NOWS的影响。
我们进行了一项回顾性研究，分析了2010年1月至2020年12月期间在两个新生儿重症监护病房因NOWS入院的婴儿的数据。
母亲在孕期接受丁丙诺啡或其他治疗、Lipsitz评分4分或更高的非早产婴儿。
在研究纳入期间，共有75名足月儿因母亲使用丁丙诺啡替代治疗而住院治疗NOWS。所有剂量组的NOWS持续时间差异显著，母亲丁丙诺啡维持剂量越高，NOWS持续时间越长。高剂量暴露组婴儿需要17天[10；23]，中剂量暴露组婴儿需要7天[2；16]，低剂量暴露组婴儿需要3天[2；5]，p值<0.003。与其他组相比，高剂量暴露组婴儿恢复出生体重所需时间更长，治疗所需吗啡剂量更高。低剂量、中剂量和高剂量丁丙诺啡暴露组婴儿的住院时间分别呈剂量依赖性增加。
孕期母亲丁丙诺啡剂量增加与NOWS严重程度相关。我们的研究表明，孕期母亲丁丙诺啡剂量增加与NOWS严重程度相关。探索低剂量及不同剂量范围是界定母亲丁丙诺啡使用影响的新依据。
