Gestational buprenorphine-naloxone exposure and fetal neurobehavior.

Autor: Jansson LM; Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD 21224, USA. Electronic address: ljansson@jhmi.edu., McConnell K; Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD 21224, USA., Velez ML; Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, MD 21224, USA., Spencer N; Johns Hopkins Bayview Medical Center, Department of Nursing, Baltimore, MD 21224, USA., Milio L; Johns Hopkins University School of Medicine, Department of Gynecology and Obstetrics, Baltimore, MD 21224, USA., Leoutsakos J; Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, MD 21224, USA., DiPietro JA; Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, Baltimore, MD 21224, USA.
Jazyk: angličtina
Zdroj: Neurotoxicology and teratology [Neurotoxicol Teratol] 2024 Jul-Aug; Vol. 104, pp. 107368. Date of Electronic Publication: 2024 Jun 19.
DOI: 10.1016/j.ntt.2024.107368
Abstrakt: Background: Buprenorphine-naloxone treatment may confer substantial benefits for the treatment of opioid use disorder (OUD) during pregnancy including lower risk for overdose/death, less diversion potential and reduced use of other substances. Treatment may also result in less severe Neonatal Abstinence Syndrome (NAS), but little is known about the effects of this medication on fetal neurodevelopment.
Methods: The purpose of the current study is to evaluate neurobehaviors among fetuses exposed to buprenorphine-naloxone at four time points over the second and third trimesters of gestation in pregnant women with OUD on buprenorphine-naloxone therapy. Sixty minutes of continuous fetal monitoring via fetal actocardiograph with a single wide array abdominal transducer took place at times of peak and trough buprenorphine-naloxone levels in 24 pregnant women. Data collection, which included measures of fetal heart rate and motor activity, was conducted between 24 and 36 weeks gestation, with the majority (84.6%) monitored at two or more gestational ages. Medication dose and other substance use was monitored throughout the study and infant NAS severity was assessed.
Results: Fetal heart rate (FHR), FHR variability, accelerations in FHR, and motor activity were suppressed when buprenorphine-naloxone levels were at pharmacologic peak as compared to trough concentrations at 36 weeks, but not earlier in gestation. Maternal medication dose was unrelated to infant NAS severity.
Conclusions: Conclusions: There were evident subclinical fetal neurophysiological responses at times of peak maternal buprenorphine/naloxone levels in later gestation, similar to those previously described for buprenorphine only. Further studies evaluating the effects of these changes in fetal neurobehaviors on the longer-term infant development are needed.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Lauren Jansson reports financial support was provided by National Institute on Drug Abuse. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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