722 - Does weaning of buprenorphine in opioid use disorder pregnancy improves neonatal (neurological) outcome in infants ?

Poster Number: 722
Publication Number: 722.244

Darshan Shah, East Tennessee State University James H. Quillen College of Medicine, Jonesborough, TN, United States; Rakesh Adelli, East Tennessee State University James H. Quillen College of Medicine, Johnson City, TN, United States; Alyson Chroust, East Tennessee State University, Johnson City, TN, United States

Background: Opioid use disorder (OUD) in pregnancy is managed mainly by continuing opioid (without weaning) as per recommendation by the American College of Obstetrics and Gynecology (ACOG) and the American Society of Addiction Medicine (ASAM) despite some research showing that weaning of opioid is possible in pregnant women without any harm to the mothers and newborns.

Objective: The objective of the study was to look at the neonatal outcome of weaning opioid in pregnant women and comparing with the non-weaning of opioid in OUD pregnancy. The neonatal outcomes of interest were the development of neonatal opioid withdrawal syndrome (NOWS), length of stay (LOS), need for morphine, admission to Neonatal intensive care unit (NICU), birth weight and head circumference.

Design/Methods: It was an IRB-approved, prospective study where consent of the weaning group mothers was obtained in an antenatal university clinic. Patients agree with the obstetric clinic provider for weaning of opioid, which is done at the provider's discretion depending on the history, tolerance, and other factors. Some mothers were able to wean off Subutex before delivery, while others were able to wean down to 2mg per day, which was considered a weaning group (WG). Non-weaning group (NWG) of the patients were recruited from the hospital at the time of delivery. Maternal and neonatal details of interest were extracted from the electronic health record. T test and odds ratio were used to look at the difference in both groups by SSPR software.

Results: There were 77 pregnant patients, with 50 in WG and 27 in NWG in the study. Characteristics of WG and NWG have been shown in table 1 with no statistically significant difference in both groups concerning marital status, socioeconomic and education level. Only difference between WG and NWG is the dose of Subutex with p < 0.001. Characteristics of both groups of infants have been shown in table 2. There is a statically significant difference in both neonatal groups concerning the length of stay, need for morphine, need for ICU admission, and head circumference (P < 0.05 for all), with infants of NWG 3 times more likely to be admitted to ICU and 2 times likely to require morphine for treatment of NOWS.






























































































































Conclusion(s): Weaning of opioid in OUD pregnancy improves head circumference and probable neurological outcome along with LS, and morphine need.