Buprenorphine exposure in infants of opioid-dependent mothers at birth

Background: Buprenorphine, a partial opioid agonist used in treating opioid dependence, is not approved in Australia for use in pregnancy. Nevertheless, many pregnant women choose to remain on the drug. Aim: To investigate cord/maternal transfer ratios for buprenorphine and norbuprenorphine in women...

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Main Authors: Bartu, Anne, Ilett, K., Hackett, L., Doherty, D., Hamilton, D.
Format: Journal Article
Published: Wiley-Blackwell Publishing Asia 2012
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/23459
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author Bartu, Anne
Ilett, K.
Hackett, L.
Doherty, D.
Hamilton, D.
author_facet Bartu, Anne
Ilett, K.
Hackett, L.
Doherty, D.
Hamilton, D.
author_sort Bartu, Anne
building Curtin Institutional Repository
collection Online Access
description Background: Buprenorphine, a partial opioid agonist used in treating opioid dependence, is not approved in Australia for use in pregnancy. Nevertheless, many pregnant women choose to remain on the drug. Aim: To investigate cord/maternal transfer ratios for buprenorphine and norbuprenorphine in women at delivery. Methods: Maternal and cord serum samples were collected from 10 maternal-infant pairs at delivery. Drug concentrations were measured by liquid chromatography-tandem mass spectrometry. Maternal and infant demographic information was collected. Linear regression was used to assess the relationship between maternal and cord measurements. Results: Median (interquartile range) maternal age was 27 (23.8–32) years, with 90% of the women on buprenorphine before pregnancy. Median infant birthweight was 3148 (3088–3545) g and 60% of infants had neonatal abstinence requiring admission to a neonatal intensive care unit for a median of 8.5 (2.5–16.3) days. Median maternal buprenorphine daily dose was 8.5 mg (range 1–28 mg). Mean (95% confidence interval) cord serum concentrations of buprenorphine and norbuprenorphine were 0.4 (0.3–0.5) μg/L and 1.2 (0.9–1.4) μg/L, respectively. Mean maternal concentrations of buprenorphine and norbuprenorphine were 1.0 (0.6–1.4) μg/L and 1.2 (0.9–1.4) μg/L, respectively. Mean cord/maternal ratios were 0.43 (0.36–0.5) for buprenorphine and 0.53 (0.43–0.63) for norbuprenorphine. Maternal buprenorphine and norbuprenorphine concentrations and ratio of buprenorphine/norbuprenorphine explained 85.7, 69.6 and 94.4%, respectively, of variation in the corresponding cord concentrations. Conclusion: Usual therapeutic doses of buprenorphine administered to pregnant women resulted in low concentrations of buprenorphine and norbuprenorphine in maternal serum and a low transfer to the fetal circulation (cord plasma) at birth.
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spelling curtin-20.500.11937-234592017-09-13T15:59:55Z Buprenorphine exposure in infants of opioid-dependent mothers at birth Bartu, Anne Ilett, K. Hackett, L. Doherty, D. Hamilton, D. buprenorphine infant exposure at delivery norbuprenorphine placental transfer Background: Buprenorphine, a partial opioid agonist used in treating opioid dependence, is not approved in Australia for use in pregnancy. Nevertheless, many pregnant women choose to remain on the drug. Aim: To investigate cord/maternal transfer ratios for buprenorphine and norbuprenorphine in women at delivery. Methods: Maternal and cord serum samples were collected from 10 maternal-infant pairs at delivery. Drug concentrations were measured by liquid chromatography-tandem mass spectrometry. Maternal and infant demographic information was collected. Linear regression was used to assess the relationship between maternal and cord measurements. Results: Median (interquartile range) maternal age was 27 (23.8–32) years, with 90% of the women on buprenorphine before pregnancy. Median infant birthweight was 3148 (3088–3545) g and 60% of infants had neonatal abstinence requiring admission to a neonatal intensive care unit for a median of 8.5 (2.5–16.3) days. Median maternal buprenorphine daily dose was 8.5 mg (range 1–28 mg). Mean (95% confidence interval) cord serum concentrations of buprenorphine and norbuprenorphine were 0.4 (0.3–0.5) μg/L and 1.2 (0.9–1.4) μg/L, respectively. Mean maternal concentrations of buprenorphine and norbuprenorphine were 1.0 (0.6–1.4) μg/L and 1.2 (0.9–1.4) μg/L, respectively. Mean cord/maternal ratios were 0.43 (0.36–0.5) for buprenorphine and 0.53 (0.43–0.63) for norbuprenorphine. Maternal buprenorphine and norbuprenorphine concentrations and ratio of buprenorphine/norbuprenorphine explained 85.7, 69.6 and 94.4%, respectively, of variation in the corresponding cord concentrations. Conclusion: Usual therapeutic doses of buprenorphine administered to pregnant women resulted in low concentrations of buprenorphine and norbuprenorphine in maternal serum and a low transfer to the fetal circulation (cord plasma) at birth. 2012 Journal Article http://hdl.handle.net/20.500.11937/23459 10.1111/j.1479-828X.2012.01424.x Wiley-Blackwell Publishing Asia restricted
spellingShingle buprenorphine
infant exposure at delivery
norbuprenorphine
placental transfer
Bartu, Anne
Ilett, K.
Hackett, L.
Doherty, D.
Hamilton, D.
Buprenorphine exposure in infants of opioid-dependent mothers at birth
title Buprenorphine exposure in infants of opioid-dependent mothers at birth
title_full Buprenorphine exposure in infants of opioid-dependent mothers at birth
title_fullStr Buprenorphine exposure in infants of opioid-dependent mothers at birth
title_full_unstemmed Buprenorphine exposure in infants of opioid-dependent mothers at birth
title_short Buprenorphine exposure in infants of opioid-dependent mothers at birth
title_sort buprenorphine exposure in infants of opioid-dependent mothers at birth
topic buprenorphine
infant exposure at delivery
norbuprenorphine
placental transfer
url http://hdl.handle.net/20.500.11937/23459