Journal de recherche et de thérapie en toxicomanie

Abstrait

Childhood Health and Development in a Cohort of Infants Exposed Prenatally to Methadone or Buprenorphine

Olivia Humbarger, Daniel Galanto, Kelley Saia, Sarah M Bagley, Elisha M Wachman and Susan B Brogly

Background: Neonatal Abstinence Syndrome (NAS) due to in-utero opioid exposure is a growing problem with largely unknown long-term childhood outcomes. The objective of this study was to compare long-term outcomes of infants exposed to methadone versus buprenorphine in-utero.
Method: This retrospective cohort study included all pregnant women on buprenorphine or methadone and their infants born between 2006-2010 at our institution. Inpatient data was merged with outpatient data from 2006-2014 for those infants who continued to receive their paediatric care at our institution. We estimated unadjusted risk ratios (RR) of the following outcomes in buprenorphine versus methadone exposed infants: 1) routine healthcare visits, 2) growth and feeding disorders, 3) developmental delay, 4) visual problems, 5) hearing problems, 6) behavioural/attentional problems.
Results: Of 338 infants, 73.1% (N=247) continued to be followed at our hospital. The mean length of follow-up was 25.7 months (95% CI 22.9, 28.9). Infants in the buprenorphine group were less likely to be seen for hepatitis C exposure (19.6 vs. 9.2%, RR=0.60, 95% CI 0.40, 0.91) and more likely to have had a routine weight check (RR=2.14, 95% CI 1.05, 4.34). There were no differences in the incidence of developmental delay, ophthalmologic abnormalities, hearing deficits, or behavioural diagnoses between the groups. Results are limited by small sample size and lack of adjustment for confounders.
Conclusion: No significant differences in paediatric outcomes at 2 years of age after in-utero methadone or buprenorphine exposure were found, but the evidence is affected by study limitations. Further studies in a large patient population are warranted.