BAMBINO Study: Buprenorphine and Methadone Backdated Investigation of Neonatal Outcomes; In Neonatal Abstinence Syndrome

Abstract

Specific Aims: This study aimed to compare the impact of maternal buprenorphine and methadone use during pregnancy on the primary outcome of neonatal hospital length of stay as well as secondary neonatal outcomes,

Methods: This was a retrospective, IRB-approved, observational cross-sectional study of neonates born to mothers with a documented record of medication-assisted treatment (MAT) with either methadone or buprenorphine. The primary outcome of the study was neonatal hospital length of stay in hours. Secondary outcomes included peak Finnegan score, peak morphine and clonidine dose, and total amount of morphine and clonidine administered. Using regression analyses, these primary and secondary neonatal outcomes were adjusted for maternal polysubstance and psychotropic use.

Main Results: A total of 119 neonates born to mothers on MAT therapy were included in this analysis (buprenorphine n = 21, methadone n = 98). Neonates born to mothers treated with buprenorphine had a shorter hospital length of stay (mean difference - 278.6 hours, CI -459.43 to -91.30, p = 0.0037). Neonates in the buprenorphine group had significantly lower peak Finnegan scores (mean difference 2.0146, SE = 0.9465, CI 0.1383 to 3.8909, p = 0.0356). There were no significant differences in the other secondary outcomes.

Conclusions: Maternal MAT with buprenorphine was associated with a shorter neonatal hospital length of stay and lower peak Finnegan score compared to methadone, with no significant difference in the other secondary outcomes. This analysis attempts to add to the understanding of neonatal outcomes born to opioid-dependent mothers on MAT.