Abstract
There is lack of knowledge about the safety of treatment with methadone and buprenorphine as part of opioid maintenance treatment (OMT) during pregnancy. The purpose of this study was to examine neonatal outcomes concerning the use of OMT during pregnancy. We used nationwide registry linkages from the Czech Republic (2000‐2014) and Norway (2004‐2013). We compared prenatally OMT–exposed newborns with (a) newborns of women hospitalized with opioid use disorder during pregnancy in the Czech sample and (b) newborns with neonatal abstinence syndrome (NAS) in Norway. We performed multivariate linear and binary logistic regression exploring the associations between OMT and neonatal outcomes (growth parameters, gestational age, fetal death, small for gestational age, Apgar score, and NAS). Regression coefficients (b) and odds ratios (ORs) were estimated. The cohorts consisted of 333 Czech, and 235 Norwegian OMT–exposed newborns, and 106 and 294 newborns in the comparison groups, respectively. In both countries, the neonatal growth parameters were similar in the OMT and the comparison groups. In Norway, OMT exposure prolonged gestational age (adjusted b = 0.96 weeks, 95% confidence interval [CI] =0.39‐1.53) while the odds of preterm birth and Apgar score at 5 minutes were lower than in the comparison group (adjusted OR = 0.35, 0.16‐0.75 and aOR = 0.21, 0.06‐0.78, respectively). Newborns of women in OMT had similar growth parameters as newborns of women with opioid use disorders who were not in OMT during pregnancy. Overall, our findings do not suggest that OMT results in worse neonatal outcomes.
Highlights
INTRODUCTION AND BACKGROUNDOpioid use disorder is characterized by the persistent use of opi‐ oids despite the adverse consequences of its use
We show maternal socioeconomic char‐ acteristics, as well as neonatal outcomes in the opioid maintenance treatment (OMT)–exposed new‐ borns compared to newborns of women in OMT before and after pregnancy and compared to all the children in the general population
We found no sig‐ nificant differences in neonatal growth parameters between OMT–exposed newborns and newborns of drug‐using pregnant women not in OMT during pregnancy
Summary
INTRODUCTION AND BACKGROUNDOpioid use disorder is characterized by the persistent use of opi‐ oids despite the adverse consequences of its use. In the Czech Republic, 333 women were in OMT during pregnancy, while 106 had opioid use disorder without being in OMT during pregnancy. In both countries, women in the comparison groups were younger than women in OMT. In the Norwegian sample, the pregnant women in the OMT group had lower education levels (primary education 71.5% versus 50.0%) and higher smoking prevalence (68.5% versus 57.2%) during pregnancy than the comparison group (Table 2). In the Czech Republic, the gestational age was similar between the OMT‐exposed and the comparison group (38.4 weeks), while in Norway the OMT‐ exposed had 0.9 weeks longer gestational age than those not ex‐ posed. Independent of exposure to OMT or not, the mean growth
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