Use of naltrexone in treating opioid use disorder in pregnancy

American Journal of Obstetrics and Gynecology
Craig V TowersKevin C Visconti

Abstract

The mainstay of managing opioid use disorder in pregnancy is with methadone or buprenorphine medication assisted treatment (MAT). Methadone and buprenorphine are opioid agonist drugs. Naltrexone, an opioid antagonist, is also a MAT option, but to date, only a few retrospective studies have reported its use in pregnancy. Our study objective was to prospectively evaluate obstetric and newborn outcomes and the maternal/fetal effects of the use of naltrexone as a MAT in pregnant patients with opioid use disorder (OUD). We performed a prospective cohort study collecting data on all pregnant women who were managed with naltrexone MAT compared with pregnant women managed using methadone or buprenorphine MAT. Based on a sample size calculation, it was determined that for a power of 90, a minimum of 160 study participants (80 in each group) was needed using an alpha of .01 and an expected 60% rate of newborns treated for NAS in the methadone or buprenorphine MAT group compared with a 30% rate in the naltrexone MAT group. In a random subset of 20 maternal/newborn dyads, blood levels for naltrexone and 6-beta-naltrexol (an active metabolite) were analyzed at delivery. A total of 230 patients were studied, 121 naltrexone MAT compared with ...Continue Reading

References

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Dec 12, 2018·Pediatrics·Craig V TowersKimberly B Fortner
Jan 3, 2019·The New England Journal of Medicine·Amy S B Bohnert, Mark A Ilgen

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Citations

Sep 19, 2020·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Monika SarkarNorah A Terrault
Apr 2, 2020·Cold Spring Harbor Perspectives in Medicine·Andrew E WellerWade H Berrettini
Jun 9, 2021·International Anesthesiology Clinics·Laurence E Ring, Ruth Landau
Sep 10, 2020·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Lisa GravesJocelynn L Cook
Sep 10, 2020·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Dre Lisa GravesJocelynn L Cook

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