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Войти в исследования Drug and alcohol dependence · 2025
Buprenorphine-naloxone versus buprenorphine for opioid use disorder during pregnancy: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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de Lima Fernanda Ribeiro, Molino Gabriela Oliveira Gonçalves, Gallo Ruelas Mariano, Barbosa Eduardo Cerchi, Silva Pedro Henrique Costa Matos da, Guimarães Felipe Bandeira de Melo, Petrucci Arthur Bezerra Cavalcanti, Silva Giovanna Hanike Santos da, Sbardelotto Ângelo Eduardo Espíndola, Lança Saulo Bernardo, Garbacka Alicja
Аннотация
BACKGROUND: The standard of care for treating opioid use disorder (OUD) during pregnancy includes either buprenorphine or methadone. Although buprenorphine-naloxone presents an alternative due to the reduced risk of misuse , evidence regarding its impact on pregnancy and infant health remains limited. This systematic review and meta-analysis aims to compare buprenorphine-naloxone vs buprenorphine alone for OUD during pregnancy, assessing gestational and neonatal outcomes.
METHODS: We systematically searched MEDLINE, Embase, and Cochrane Library databases to identify studies comparing buprenorphine-naloxone versus buprenorphine for OUD during pregnancy. The primary outcome assessed was neonatal abstinence syndrome (NAS). Pooled risk ratios (RR) and mean differences (MD) with 95 % confidence intervals (CI) were calculated using R statistical software and quality assessment was performed following Cochrane recommendations.
RESULTS: Six retrospective cohorts were included, encompassing 9348 mother-infant dyads, of whom 38.3 % received buprenorphine-naloxone. NAS requiring treatment (RR 0.77; 95 % CI 0.71-0.84; p < 0.01) and small for gestational age infants (RR 0.86; 95 % CI 0.76-0.98; p = 0.03) were significantly less frequent in the buprenorphine-naloxone group. No significant differences were found between the groups for cesarean delivery (RR 1.04; 95 % CI 0.98-1.11; p = 0.20), low birth weight (RR 1.07; 95 % CI 0.91-1.24; p = 0.41), and preterm delivery (RR 1.07; 95 % CI 0.96-1.21; p = 0.22).
CONCLUSION: Pregnant people treated with buprenorphine-naloxone had neonates with a lower risk of small for gestational age and NAS. Further research is needed to confirm these findings and explore other pregnancy-related and neonatal outcomes.
METHODS: We systematically searched MEDLINE, Embase, and Cochrane Library databases to identify studies comparing buprenorphine-naloxone versus buprenorphine for OUD during pregnancy. The primary outcome assessed was neonatal abstinence syndrome (NAS). Pooled risk ratios (RR) and mean differences (MD) with 95 % confidence intervals (CI) were calculated using R statistical software and quality assessment was performed following Cochrane recommendations.
RESULTS: Six retrospective cohorts were included, encompassing 9348 mother-infant dyads, of whom 38.3 % received buprenorphine-naloxone. NAS requiring treatment (RR 0.77; 95 % CI 0.71-0.84; p < 0.01) and small for gestational age infants (RR 0.86; 95 % CI 0.76-0.98; p = 0.03) were significantly less frequent in the buprenorphine-naloxone group. No significant differences were found between the groups for cesarean delivery (RR 1.04; 95 % CI 0.98-1.11; p = 0.20), low birth weight (RR 1.07; 95 % CI 0.91-1.24; p = 0.41), and preterm delivery (RR 1.07; 95 % CI 0.96-1.21; p = 0.22).
CONCLUSION: Pregnant people treated with buprenorphine-naloxone had neonates with a lower risk of small for gestational age and NAS. Further research is needed to confirm these findings and explore other pregnancy-related and neonatal outcomes.